What is Stage 3 pleural mesothelioma?
Mesothelioma is an infrequently occurring aggressive form of cancer that affects the lining surroundings of the lungs, heart, and stomach. Exposure to asbestos has been identified as the cause of this cancer.
Stage 3 pleural mesothelioma is characterized by spreading of tumors into tissues, organs (including a lung, chest wall, heart, and abdomen) and/or lymph nodes surrounding cancer’s primary site, a pattern referred to as the local spread. This is the stage at which mesothelioma is most frequently identified as it’s when most symptoms come to the fore.
The three staging systems used to classify stage 3 pleural mesothelioma
Each of the following staging systems describes stage 3 pleural mesothelioma somewhat differently:
Butchart System – The disease has spread from the original location in the lung’s pleural lining, abdomen, and surrounding areas, and may also involve the lymph node groups.
TNM System – The disease has spread to several locations in the thoracic cavity including the esophagus, diaphragm, and perhaps the heart, as well as the lymph nodes.
Brigham System (created by Dr. David Sugarbaker) – The disease has now affected organs in the thoracic cavity and one or multiple lymph node groups; surgical treatment is no longer possible.
The TNM System in more detail
Most doctors use the TNM staging system, and which was updated in January 2018. This system describes stage 3 pleural mesothelioma in two phases, i.e. 3A and 3B.
Stage 3A – The surrounding organs into which the tumors have grown include the lung’s lining, diaphragm, and mediastinum on one side of the chest. Cancer has now spread to surrounding lymph nodes and may have also affected chest wall layers and the pericardium i.e. heart sac.
Stage 3B – There are two variations for this phase and which depend on the main tumor’s size and its spread to the lymph nodes. In case cancer has remained in proximity to the original site or surrounding structures, surgical removal may be possible despite it has affected the lymph nodes. In the most advanced stages of this phase, the cancer is too far grown at the site of origin. A complete surgical removal is impossible even if surrounding lymph nodes remain unaffected.
Symptoms of stage 3 pleural mesothelioma
Considering that at this stage cancer has substantially spread beyond its area of origin the symptoms tend to be pretty intense and can be expected to become worse as metastasis continues. Typical symptoms include:
• Chest pain or tightness• General tiredness of fatigue• Labored breathing or dyspnea i.e. shortness of breath• Weight loss• Fever
Treatment options for stage 3 pleural mesothelioma
Primary treatment options for patients at this stage are chemotherapy and radiation therapy, and both can be jointly used as components of a multimodal treatment. Both procedures are mainly intended for pain relief but are also capable of increasing life expectancy.
A patient receiving the said primary treatment may also undergo surgical procedures for palliative purposes. These procedures are aimed at removing the fluid that has accumulated at the affected area and they can also be done to relieve pain. The said procedures include pleurodesis, thoracentesis, paracentesis, and pericardiocentesis.
Prognosis of stage 3 pleural mesothelioma
The general prognosis at this point is grim. Although the primary tumor can be removed remission is doubtful because cancer cells have most probably spread to other areas.
At this point, patients have a median life expectancy of approximately 18 months. Nevertheless, this life expectancy will vary depending on the individual diagnosis, with factors like gender, age, tumor cell type and location, general health, and other risk factors coming into play.