The four stages of mesothelioma help doctors determine the progression of mesothelioma cancer. Stage 1 mesothelioma is localized, and many treatment options are available. Stage 4 mesothelioma shows metastasis, meaning the cancer cells have spread throughout the chest or abdominal cavity, and symptoms are more severe.
What Are the Four Stages of Mesothelioma?
- Stage 1: Cancer cells are in one place. Surgery is an option.
- Stage 2: Cancer cells enter lymph nodes. Surgery remains an option.
- Stage 3: Cancer cells spread to nearby organs and distant lymph nodes. Surgery may be an option. Chemotherapy is more common at this stage.
- Stage 4: Cancer cells extend throughout or beyond chest or abdominal cavity. Surgery is no longer an option. Chemotherapy may improve life expectancy and ease symptoms.
The stages of mesothelioma are based upon the size of tumors and how far they have spread. The location and size of tumors has a direct impact on the symptoms a person may feel.
People often wonder if they can determine their stage based on their symptoms. Unfortunately, the symptoms of mesothelioma are not strongly correlated with the stages.
One of the reasons mesothelioma tends to be diagnosed in a late stage is the fact that early stages of mesothelioma cause no symptoms. The cancer is small in early stages and does not affect the body the way larger, late-stage tumors do.
Staging is a key part of mesothelioma diagnosis and treatment. Doctors use cancer stage as a guideline when deciding whether a patient is likely to benefit from treatments such as surgery.
Stage 1 Mesothelioma
- Initially, tumor growth is within a single area.
- The prognosis and life expectancy of stage 1 mesothelioma is significantly better than later stages.
- It is difficult to catch the cancer this early because people with this stage do not usually experience symptoms.
Symptoms: Most mesothelioma patients do not experience symptoms at stage 1. At this stage, tumors are too small to cause pain or breathing difficulties.
Treatment: Stage 1 mesothelioma is treated with surgery, chemotherapy and radiation therapy. This approach is called multimodal therapy. Major surgery to remove the cancer is usually the first line of treatment.
Life Expectancy: People diagnosed at this stage have the greatest chance of living longer with mesothelioma. Median life expectancy at stage 1 is 22.2 months with surgery.
Stage 2 Mesothelioma
- Stage 2 indicates that tumors are beginning to spread beyond the mesothelial lining and into lymph nodes.
- Tumors remain small enough to be removed by surgery, which positively impacts life expectancy.
Symptoms: Stage 2 pleural mesothelioma symptoms, such as difficulty breathing during exercise or a mild cough, may resemble the common cold. Peritoneal patients may lose weight or feel bloated. It is generally rare for symptoms to appear in stage 2. Symptoms usually arise in stage 3.
Treatment: Stage 2 mesothelioma is treated with surgery, chemotherapy and radiation therapy. The same multimodal approach to treatment used at stage 1 is also used in stage 2.
Life Expectancy: Those who respond well to aggressive treatment may live longer than three to five years. Median life expectancy at stage 2 is 20 months with surgery.
Free Mesothelioma Nutrition Guide
Eating right and balancing your diet while undergoing mesothelioma treatment can help ease your symptoms.
Stage 3 Mesothelioma
- Once the cancer progresses to stage 3, it may have spread to several tissues, organs and lymph nodes in the same region of the body where it formed.
- Some stage 3 patients qualify for surgery depending upon the size and location of tumors.
Symptoms: Stage 3 pleural symptoms include difficulty breathing, dry cough, wheezing and chest pain. Peritoneal patients develop constipation or diarrhea, abdominal pain and bloating. Both types may experience weight loss, fever and night sweats.
Treatment: Stage 3 mesothelioma is typically treated with chemotherapy because most stage 3 patients are ineligible for surgery. At that point, doctors offer palliative options to control pain, improve quality of life and extend survival. Stage 3 patients can join clinical trials to try new chemotherapy drugs and immunotherapies.
Life Expectancy: Some patients who qualify for surgery can live for years with stage 3 mesothelioma. Median life expectancy at stage 3 is 17.9 months with surgery.
Stage 4 Mesothelioma
- By stage 4, cancer has spread throughout the area where it first developed and possibly to other parts of the body. Cancer could be present in the liver, brain, bones or elsewhere.
- Tumor-removing surgery is not used at this stage. Minimally invasive surgeries may be used to control symptoms.
Symptoms: Stage 4 pleural symptoms include extreme difficulty breathing, trouble swallowing and severe chest pain. Peritoneal symptoms include constant digestive problems, swelling of the abdomen, bowel obstruction and difficulty breathing or swallowing. Both types may experience loss of appetite, weight loss, muscle weakness, nerve pain, night sweats, fever and fatigue.
Treatment: Stage 4 mesothelioma is treated with chemotherapy and palliative care to ease pain, control symptoms and extend survival. Many stage 4 patients qualify for clinical trials testing chemotherapy and immunotherapy.
Life Expectancy: Some stage 4 patients have lived longer than a year with mesothelioma. Treatments such as chemotherapy and immunotherapy help people live longer at this stage. Median life expectancy at stage 4 is 14.9 months or less with or without surgery.
Metastasis in the Final Stage
Metastasis means that cancer has spread to a distant body part from where it first developed. This only happens in stage 4, the last stage of mesothelioma.
Unlike other cancers, mesothelioma tends to metastasize locally rather than distantly. Mesothelioma is more likely to spread throughout the body cavity where it originated – either the chest cavity or the abdominal cavity – rather than spread to distant body parts such as the brain.