Oncologists and mesothelioma doctors use a rubric or “staging” system when determining the extent and nature of any kind of cancer, including mesothelioma. This is only one of the standards by which malignancies are classified—the first of which is determined by the location of the tumor and the third of which is determined by the mesothelioma cell types.
Staging assists the oncologist in determining the rate of progression of the asbestos cancer and how to best design a course of treatment specific to the patient's malignancy.
Although there are three distinct staging systems currently in use, all three are based on four primary mesothelioma stages:
In stage 1 mesothelioma, the tumor is confined to one organ or region and is relatively small.
In stage 2 mesothelioma, the tumor has grown in size, and has spread to one other tissue.
In stage 3 mesothelioma, the tumor has spread to adjacent areas.
In stage 4 mesothelioma, the tumor has spread to distant areas of the body, or “metastasized.”
Stage 3 Mesothelioma Prognosis
By the time the disease has reached Stage 3, the mesothelioma prognosis is grim. Even if the primary tumor can be removed, cancer cells have most likely spread to other areas, and a mesothelioma remission or mesothelioma cure is not probable. At this point, palliative treatments that can reduce pain and make the patient more comfortable during his/her final days are the generally the only viable options.
What are the Common Treatments for Stage 3 Mesothelioma?
With Stage 3 Mesothelioma, surgery is typically palliative. With operable tumors, surgery is an option to ease symptomatic suffering and aid in quality of life. However, surgery may only remove the main tumor, but since the cancer has spread through the lymphatic system, blood and other organs, surgery cannot remove the remaining cancerous cells.
Location of the tumor or tumors dictates whether surgery is an option or potentially detrimental to the overall health of patient.
At this stage of mesothelioma, surgery depends entirely on the individual and type of mesothelioma. In most cases, surgery is not an option.
For Stage 3 Mesothelioma patients, radiation therapy also provides symptomatic relief. Though radiation therapy typically inhibits metastases of cells, radiation therapy may specifically target areas of the body where tumors associated with Stage 3 Mesothelioma are painful and severely affect quality of life.
Administering radiation at this stage only provides palliative care.
Thoracentesis / Paracentesis / Pericardiocentesis
Thoracentesis is a palliative treatment option for pleural mesothelioma in which excess fluid is drained from the lungs. Paracentesis also drains excess fluid built up in the abdomen for peritoneal mesothelioma while pericardiocentesis drains fluids from the pericardium. These treatments alleviate pain and pressure, but do not cure the disease.
Palliative care plans are individualized and target the specific issues that each patient faces. They almost always include a pain management component, however, to ensure that the patient is not suffering.
Medical professionals may also prescribe dietary and lifestyle changes aimed at improving patient comfort. Proper nutrition and maintaining hydration is critical. Many conventional treatment options – radiation therapy or chemotherapy – rob the body of vital vitamins and minerals.
The emotional impact of Stage 3 Mesothelioma may be more painful than the disease itself, not only for the patient but also for loved ones and care givers. Counseling may be a necessary part of any palliative care plan.
Integrating alternative therapies into a conventional palliative care plan is also a viable option. Massage therapy, for example, may provide temporary relief to sore muscles and joint tissue. However, most alternative therapies provide short-term comfort and are not a replacement for conventional treatments.
Ultimately, a palliative care plan is individual. Determining what quality of life means is unique as the individual with Stage 3 Mesothelioma.
Cancer Guide. "Understanding Cancer Types and Staging." Cancerguide.org, March 2009, http://cancerguide.org/basic.html
Dodson, R. and Hammar, S. Asbestos: Risk Assessment, Epidemiology, and Health Effects. (Boca Raton:Taylor & Francis, 2006.)
Galateau-Salle, Francoise. Pathology of Malignant Mesothelioma. (London: Springer-Verlag London Limited, 2006.)