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Stages of Mesothelioma

Legally Reviewed by Joseph P. Williams on November 29, 2023

Classifying the stage of mesothelioma is a very important part of the diagnosis process. In a patient with mesothelioma, the stage represents the size of the tumors and how much they have spread (metastasized). A doctor must identify the stage of mesothelioma to determine the best course of treatment for the patient. The stage also determines the patient’s prognosis and life expectancy. In general, the smaller the stage, the better the prognosis.

What Are the Stages of Pleural Mesothelioma?

Doctors break down pleural mesothelioma diagnoses into four stages. Stage 1 has the best prognosis for recovery, while stage 4 has the worst. In general, a patient may only notice slight symptoms of pleural mesothelioma in the early stages, but symptoms will become more pronounced by stage 3. Determining the stage of mesothelioma is one of the first steps in mesothelioma treatment.

4 stages of Mesothelioma

Stage 1 Mesothelioma

The cancerous cells are localized, meaning they are only in one location. They are located in the pleura, or the lining of the lungs, and have not spread elsewhere in the body or tissues.

It is often hard to diagnose pleural mesothelioma in stage 1, as the symptoms may not yet be noticeable. Stage 1 mesothelioma often has no major symptoms and is instead diagnosed by accident when a doctor is searching for another illness using scans or x-rays.

Stage 1 pleural mesothelioma is the very beginning of the cancer journey. Initially, tumor growth remains within a single area. Over time, due to the fact that there is no known cure for mesothelioma, the cancer will eventually spread. However, with treatments, a patient with stage 1 mesothelioma can typically extend his or her life expectancy.

A patient diagnosed with stage 1 pleural mesothelioma has the best odds of living longer compared to patients with more advanced stages. The average life expectancy for stage 1 pleural mesothelioma is 1 to 22 months, although many patients have lived much longer with successful treatments.

Stage 2 Mesothelioma

The cancer has spread to one of the lungs, as well as the lymph nodes and possibly the diaphragm.

Stage 2 pleural mesothelioma shows some signs of the cancer spreading, although it will still only remain in one lung. Slight symptoms may begin to appear as the tumor begins to affect the lung, causing some trouble breathing, chest pain or a cough.

The prognosis and life expectancy for a patient diagnosed with stage 2 mesothelioma are similar to stage 1. Stage 2 patients are eligible for treatments that could extend their life expectancies, including surgery and chemotherapy.

Stage 3 Mesothelioma

The cancer has continued to metastasize, spreading to nearby tissues, such as the abdomen, chest wall and chest cavity.

In stage 3, the patient may begin to notice more pronounced symptoms of pleural mesothelioma, such as a chronic cough, trouble breathing, wheezing, chest pain, fever, night sweats or weight loss. The life expectancy of a patient with stage 3 mesothelioma is 3 to 19 months with surgery.

Stage 4 Mesothelioma

The cancer has metastasized severely, spreading throughout the chest, abdomen, neck, bones, organs, tissues and all lymph nodes.

Stage 4 comes with the most severe symptoms, as well as the most limited treatment options for the patient. Symptoms a patient may experience with stage 4 pleural mesothelioma are extreme trouble breathing, difficulty eating and swallowing, severe chest pain, loss of appetite, significant weight loss, muscle weakness, nerve pain, fever, fatigue, and night sweats. The life expectancy for a patient diagnosed with stage 4 is less than 12 months, in most cases.

Pericardial and Peritoneal Mesothelioma Staging

Pericardial mesothelioma (cancer of the lining of the heart) and peritoneal mesothelioma (cancer of the lining of the abdomen) are typically not classified into stages. Instead of placing them into stages like pleural mesothelioma, doctors typically describe these types of mesothelioma cancers as either localized or advanced. A specialist, however, will still track the progression of the cancer to determine which treatments are best for the patient.

How Is Mesothelioma Staged?

Classifying what stage of mesothelioma a patient has is part of the diagnostic procedure. Typically, a mesothelioma specialist uses the general cancer staging guidelines from the AJCC Cancer Staging Manual to stage this type of cancer. A doctor may use a variety of tests to determine the stage of the cancer when giving a pleural mesothelioma diagnosis, such as x-rays and CT scans.

The doctor will use medical tests to check the size of the tumor, the location of the tumor and signs of the disease spreading throughout the body. Then, the doctor will compare the data gathered to the official staging manual to place the mesothelioma case into one of the four stages. The doctor will then continue monitoring the patient and may change treatment options if cancerous cells or tumors spread.

Mesothelioma Treatment by Stage

The earliest stage of malignant pleural mesothelioma, stage 1, is the most treatable. This is mainly due to the fact that the cancer is isolated to only one lung, making it easier for doctors to remove. All or most treatment options will be available in stage 1. This typically means a multimodal treatment plan is available: surgery, chemotherapy and other forms of radiation therapy.

Stage 2 has the same treatment options available for a patient with stage 1, for the most part, as well as a similar prognosis. Stage 3 pleural mesothelioma is more difficult to treat, thus resulting in more limited treatment options for a patient. For example, surgery may not be a plausible option based on the size and location of the tumor, but certain types of therapies may still improve survival rates.

With stage 4 cancer, since the mesothelioma has spread throughout the body, surgery to remove the tumor is typically not an option. However, minimally invasive surgeries may be available to help alleviate pain and control symptoms. Many stage 4 pleural mesothelioma patients are also eligible for mesothelioma clinical trials for new drugs and therapies.

When To Speak to a Mesothelioma Attorney

If a doctor has diagnosed you with any type or phase of mesothelioma, you are not alone. Thousands of patients get diagnosed with mesothelioma every year. If someone had the ability to prevent your illness but negligently failed to do so, that party may be financially responsible for your treatments and other losses. Discuss your case with a mesothelioma lawyer in New York as soon as possible.

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