The TNM staging system can be used to diagnose mesothelioma staging. Stage 3 is the second highest stage of mesothelioma. Each of these stages corresponds to a different treatment and prognosis, with stage 3 more advanced that the lower stage 1 and stage 2 diagnosis. A stage 3 diagnosis involves a cancer that has progressed beyond just local tumor(s). Each stage diagnosis of mesothelioma is based upon the prior diagnosis of cancer within the T, N, M staging system, and involves a different prognosis.
Stage 3 Mesothelioma
Multiple possibilities exist for the diagnosis of a stage 3 mesothelioma:
Stage 3 TNM staging:
T1/T2, N1/N2, M0: Stage 2 development of the primary tumor (T1/T2), plus involvement in the local lymph nodes (N1/N2).
T3, N0-N2, M0: The elements of a stage 2 mesothelioma diagnosis, plus the primary tumor has advanced into the fatty tissue of the mediastinum or into the heart itself (T3). This diagnosis can also involve lymph node progression (N1/N2). The diagnosis is still free of distant involvement of lymph nodes or organs.
Stage 3 Mesothelioma Treatment
Stage 3 mesothelioma has progressed locally into tissues or organs, and may involve local lymph nodes, but has not yet invaded into distant sites. This makes stage 3 mesothelioma a potential candidate for surgery to resect the tumor. Resection surgery is intended to help extend the expected lifespan of the patient. In some patients resection surgery is also intended to alleviate symptoms associated with the progression and growth of tumors.
What are the Symptoms Associated with Stage 3 Mesothelioma?
Stage 3 mesothelioma has developed in size enough that a patient may have experienced symptoms, and in fact may have been diagnosed after seeking treatment for symptoms. Symptoms include shortness of breath, difficulty breathing, mild or severe chest pain coughing, and tightness in the chest. The pressure can be a sign of fluid buildup in the lining of the lungs. A patient may have more advanced symptoms and sought treatment for symptoms similar to bronchitis or pneumonia.
Unfortunately these symptoms are also common with many ailments. As a result the eventual diagnosis of mesothelioma occurs after it has progressed to a more advanced stage such as stage 3.
Stage 3 Prognosis
At stage 3, the cancer has invaded local tissues and organs and the lymphatic system. As the diagnosis is free of metastatic movement of the cancer to distant sites or organs, aggressive treatment with surgery is frequently possible. A diagnosis of stage 3 mesothelioma can be followed with aggressive treatment, and patients with a stage 3 diagnosis can be candidates for surgery to remove primary tumors.
The average life expectancy for a patient diagnosed with stage 3 mesothelioma who undergoes aggressive treatment is approximately 1-2 years.
Stage 3 Surgery Treatement
Surgery to remove tumors discovered with a stage 3 diagnosis involves the removal of all tumors both visible and capable of being excised. In addition typically a surgeon will remove any surrounding tissue that can be safety removed as the edge of the tumor can be difficult to view or determine, and with stage 3 mesothelioma any tissue in the area including pleura tissue may be cancerous. The doctor and patient may wish to proceed with an extrapleural pneumonectomy.
The surgery to remove tumors and surrounding tissues is known as a pleurectomy. An extrapleural pneumonectomy also removes additional heart lining, lymph nodes, portions of the diaphragm and one lung. A stage 3 diagnosis likely makes the latter surgery necessary to attempt to resect all tumors. In some patients the progression of cancer may be such that resection of all tumors is not possible. A patient and doctor can decide together what decisions to make regarding surgery treatment in each individual case.
A doctor may not know the extend of tumor growth until surgery, so communication between a doctor and patient prior to surgery is critical. A doctor and patient should discuss what may be discovered during a surgery, and what the patient wishes to have performed in different situations.
Stage 3 Care
Your doctor may decide that due to the possible presence of cancer cells beyond the tumor site, and the nature of mesothelioma diagnosis and the typical progression of mesothelioma cancers, additional aggressive therapy is required. Even after a surgery to remove tissue and tumors, your doctors may recommend radiation and/or chemotherapy after resection surgery.
The combination of chemotherapy and radiation therapy is known as multimodal therapy. Multimodal means multiple types, in this case the combination of both chemo and radiation therapies.
Radiation therapy: Used to shrink any tumors not removed by surgery and to reduce the risk of recurrence of tumors.
Chemotherapy: Used to kill cancer cells that remain after resection surgery. One version used “heated chemotherapy” to try and prolong survival times in patients.
A patient may decide to pursue therapy aimed at improving quality of life, not just expected lifespan. Patient therapy to improve patient condition but not life expectancy is known as “Palliative Therapy”. This therapy may include treatment to reduce symptoms caused by tumor growth, and may include surgery to remove tumors depending on their location.
Treatment includes the removal of fluid buildup around organs. Treatments include pericardiocentisis, paracentisis, or thoracentesis. Each of these procedures removes the fluid found around the heart, abdomen or chest respectively.
Stage 3 Mesothelioma Life Expectancy
While patients with stage 3 mesothelioma may undergo resection surgery to remove tumors, even after complete removal of tumors and surrounding tissue it is expected that cancer will return. With stage 3 mesothelioma some tumors may not be accessible to a surgeon to remove. Resection can increase life expectancy in some patients, or can be used as a palliative treatment to improve quality of life and reduce symptoms.
Patients that underwent aggressive treatment had an average lifespan of approximately 1-2 years.
Other Stages of Mesothelioma
To read more about other stages of mesothelioma, click here:
More Information about Mesothelioma
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