End Stage Mesothelioma What To Expect – Mesothelioma stages are used to categorize the spread and location of this cancer throughout the body. A doctor determines the stage of a patient’s malignant mesothelioma when they are first diagnosed and identifies the appropriate treatment.
Registered Nurse Amy Fair discusses the 4 stages of mesothelioma and why it’s important to talk to your doctor about the stages of mesothelioma. See Transcript.
End Stage Mesothelioma What To Expect
There are 4 stages of mesothelioma as there are with most cancers. Stage 1 mesothelioma is in the pleura. Stage 2 of this disease has reached outside the pleura and attacked the fatty tissue of the lung or diaphragm. Stage 3 is where it metastasizes in local organs and stage 4 is where it metastasizes in distant organs, lymph nodes, and tissues.
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This stage is as important in mesothelioma as it is in any cancer. It runs your prognosis; manage your treatment methods. It is important to know whether you are a candidate for surgery and the stage of your disease that drives the decision. It is important to discuss the stage after you have a CT or PET scan with your surgeon or oncologist.
The four stages of mesothelioma are based on the tumor-node-metastasis (TNM) staging system. The TNM system is the global standard for classifying the spread of cancer.
Mesothelioma staging helps doctors determine what type of treatment to use and how aggressive it is. Some treatments are used for early stage cancers, while others are used mainly for advanced stages of mesothelioma when patients may no longer qualify for invasive surgery.
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“Mesothelioma staging is as important in mesothelioma as in any cancer. It drives your prognosis. It drives your treatment.” – Quote from Amy Fair, RN, Mesothelioma Patient Advocate
Knowing the stage of their cancer gives mesothelioma patients an idea of what to expect in terms of their health and life expectancy. This information can help them make more informed choices and actively participate in their care plans.
Pleural mesothelioma forms in the lining of the lungs (pleura) and is the only type of cancer that is officially staged using the TNM system. Although peritoneal mesothelioma does not have an official mesothelioma staging system, doctors can tell patients how advanced the cancer is to help them better understand their prognosis.
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Nearly 50% of pleural mesothelioma patients are diagnosed at stage 4, according to the 2023 revision of the National Cancer Database (NCDB).
Patients have a variety of treatment options that can increase their life expectancy by months or years.
Most stage 3 mesothelioma patients are no longer eligible for surgery but can still receive treatment to help slow the spread of the disease and manage symptoms.
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In stage 4, the cancer has spread far beyond the chest wall into the bones, brain, liver, or other distant parts of the body. Treatment during this stage is focused on reducing symptoms and giving the patient the best quality of life.
Use our Free Doctor Match to find the best mesothelioma specialist near you who can develop a personalized treatment plan based on your mesothelioma stage.
Doctors do not have enough data from case studies to accurately assign a TNM stage for these other types of mesothelioma:
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Despite the lack of an official staging system, doctors can still use diagnostic tools such as MRI scans (magnetic resonance imaging), CT scans (computed tomography) and tumor marker tests to see if and how the cancer has spread.
The stage of mesothelioma plays a large role when doctors consider treatment options. The stage of mesothelioma can determine whether the cancer is resectable (can be removed by surgery) and whether the patient is healthy enough to undergo major surgery or other invasive cancer treatments.
Doctors may decide to focus mesothelioma treatment on life-prolonging or palliative (symptom-relieving) options depending on the stage of the cancer, the patient’s personal wishes and other factors.
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This is the earliest point in the development of mesothelioma. During this stage, the cancer is still in the lining of the breast and may not cause symptoms. Stage 1 mesothelioma patients have the best prognosis and are generally good candidates for various types of treatment.
Unfortunately, it is very rare to be diagnosed at stage 1. According to the NCDB, the vast majority (72%) of patients do not receive a diagnosis until their cancer reaches stage 3 and 4 mesothelioma.
Stage 2 mesothelioma patients are often good candidates for curative (life-prolonging) surgery if the cancer has not spread far into the surrounding tissues and lymph nodes.
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Surgery such as pleurectomy with decoction (P/D) may be beneficial for patients with early-stage mesothelioma. According to the American Cancer Society (ACS), surgery is more likely to show long-term benefit in early-stage cancers because there is a greater chance that most of the tumor can be removed.
Although the ACS reports that mesothelioma doctors often disagree about the effectiveness of chemotherapy and radiation therapy for mesothelioma, these methods are often used as the primary treatment for patients who do not undergo surgery.
Although less common, some stage 3 patients are still candidates for surgery. The ACS notes that surgery may help end-stage patients, but the benefits are more likely to be short-term.
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Immunotherapy may also be considered a treatment option for advanced mesothelioma when surgery may not be feasible or the cancer has spread to distant organs. It can be used alone or in combination with other therapies to help slow the progression of mesothelioma, manage symptoms and improve overall quality of life.
Other non-invasive therapies such as Tumor Treating Fields (TTFields) can also be explored to disrupt the growth of cancer cells and increase survival time.
Stage 4 mesothelioma cannot be completely removed with surgery because the cancer is no longer contained to one area. Chemotherapy is usually the main treatment for stage 4 mesothelioma.
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In addition, stage 4 patients may be good candidates for immunotherapy depending on their age and general health. These patients may also benefit from newer or experimental treatments tested in mesothelioma clinical trials.
“We don’t like to see stage 4 as a death sentence. We have a stage 4 patient who is still with us and doing very well on the Keytruda® immunotherapy drug.” – Quote from Amy Fair RN, Mesothelioma Patient Advocate
Stage 4 mesothelioma patients can also seek palliative care to reduce the pain and discomfort caused by mesothelioma instead of prolonging life.
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Pleural mesothelioma is the only type of this cancer that has been studied enough to be officially staged using the tumor-node-metastasis (TNM) staging system. This staging system helps mesothelioma patients understand the expected prognosis of their disease.
The TNM system is a way to diagnose cancer that helps doctors understand how far the cancer has spread in the body. It has three main parts.
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Doctors assign numbered stages to cancer from early to advanced. This stage helps them decide on the best treatment to use and predict how the cancer is likely to respond.
The TNM system is constantly updated to include new information and research. In addition to guiding treatment decisions, TNM mesothelioma staging helps doctors communicate with each other when discussing a patient’s cancer.
Imaging tests such as X-rays, MRI scans and CT scans can help doctors see the location and spread of a patient’s mesothelioma.
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Mesothelioma doctors often take PET and CT scans at the same time to compare the areas where the cancer appears concentrated (PET scan) with a more detailed image (CT scan).
“It is important to discuss the stage of mesothelioma after you have a CT or PET scan with your surgeon or oncologist.” – Quote from Amy Fair, RN, Mesothelioma Patient Advocate
These imaging tests are an important part of mesothelioma diagnosis because they help doctors decide on the most effective treatment for each stage of a patient’s mesothelioma.
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Mesothelioma staging plays a large role in determining the prognosis of mesothelioma. When cancer spreads to other areas, there is less chance that the body will respond well to treatment. As a result, patients with late-stage mesothelioma are less likely to achieve long-term survival.
In addition, patients with late-stage mesothelioma may not be eligible for more aggressive life-extending surgery such as extrapleural pneumonectomy (EPP).
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Mesothelioma life expectancy describes how long doctors think you will live after being diagnosed. Life expectancy is affected by your age, the type and stage of your mesothelioma, and your general health at the time of diagnosis.
Patients with early-stage mesothelioma have a higher survival rate than those with advanced mesothelioma. However, there are victims who are still alive today after being diagnosed with stage 3 and stage 4 mesothelioma.
Even if you or a family member has been diagnosed at one of the later stages, Mesothelioma Hope can help you explore treatment options such as surgery, chemotherapy and immunotherapy that can improve your prognosis.
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The time it takes for mesothelioma to develop is different for each person. Generally, however, there is a 10-50 year delay between being exposed to asbestos and experiencing symptoms of mesothelioma or receiving a diagnosis.
If you are concerned about mesothelioma or think you may have been exposed to asbestos,
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