Stage III Mesothelioma

Malignant mesothelioma can be categorized according to a number of different criteria. The first level of categorization generally has to do with where the cancer started (such as the lungs, heart, or abdomen). The next step for most doctors is to "stage" the cancer, or determine how far the disease has progressed. This staging step is often the most important piece of information when determining a prognosis and treatment plan.

There are three major systems in use that doctors may use when staging a patient's mesothelioma progression. Each divides the disease into four main stages characterized by a certain size of tumor, level of metastasis, and/or operability. In each system, stage I represents a cancer that is not very far advanced, while stage IV represents a cancer that has that has greatly progressed. Patients diagnosed in stage I generally have more treatment options than patients diagnosed in later stages of development.

Stage III mesothelioma is generally considered to be at a very advanced stage of development. As a general rule, stage III indicates a cancer that has spread from its point of origin to nearby tissues and organs. In most cases, stage III includes metastasis (spreading) to the lymph nodes located nearest the primary tumor. It is important to note that there are three major staging systems used by physicians and every system categorizes tumors in four different stages. Each system uses slightly different criteria to determine staging information.

Stage III in the Butchart System

The oldest staging system is the Butchart System. This system is only used in cases of pleural mesothelioma. Under the Butchart System, the main criterion for categorization is the size of the primary tumor. A stage III designation under the Butchart System means that the cancer has spread from its point of origin (the pleural lining) to the abdominal cavity. Other locations within the body may also be affected, and it is likely that lymph nodes across the system have been affected by cancerous cells.

Stage III in the TNM System

The TNM System (Tumor, Lymph Nodes, and Metastasis) is a newer staging system sometimes used to stage malignant mesothelioma. Under the TNM System, mesothelioma is categorized according to the size of the tumor, the level of metastasis, and the degree of lymph node involvement. The TNM System is most likely to be used in cases of pleural mesothelioma, but can also be useful in staging peritoneal mesothelioma.

According to the TNM System, stage III defines a disease in which the cancer has metastasized from the pleural membrane to the heart, ribs, esophagus, and other vital organs within the chest cavity. By stage III, lymph node involvement is almost certain.

Stage III in the Brigham System

The most recent staging system developed for use with mesothelioma is the Brigham System which also uses four stages. The Brigham System takes several variables into account when staging disease development including the extent to which lymph nodes are or are not involved and the likelihood that a given tumor can be surgically removed. In the specific case of mesothelioma, the Brigham System has limited utility due to the fact that many mesothelioma cases are inoperable.

Under the Brigham System, stage III indicates a disease in which tumors are inoperable. The cancer cannot be removed surgically because cancerous cells have spread across the chest cavity. Cancer cells may be located in spots that cannot be surgically accessed, or there simply may be too many involved tissues and organs to make surgery a viable option. Lymph nodes are also likely to be affected at this stage.

Stage III Mesothelioma Diagnosis and Treatment

When a patient or doctor suspects the presence of mesothelioma, a patient will generally go through the same process when seeking a diagnosis. The first step is generally an imaging test, such as an x-ray, MRI scan, CT scan, or PET scan. This test allows physicians to get a visual picture of what is happening inside the body and doctors use these images to look for any abnormal areas to identify where cancer might be present. Imaging tests are then followed by biopsies of various tissues to determine if cancerous cells are present. Because stage III mesothelioma has generally spread beyond the point of origin, the diagnosis process will likely involve biopsies from more than one area of the body.

For a patient with stage III mesothelioma, the cancer has become involved in so many areas of the body that curative surgery is often not an option. Additionally, lymph node involvement is nearly certain at stage III - and lymph node involvement means that metastases are likely to occur. Even if the primary tumor is removed, there may still be cancer cells in other areas of the body.

Stage III mesothelioma is generally treated with palliative options. Palliative treatments differ from curative treatments in that they do not seek to remove or "cure" the cancer. Instead, palliative treatments aim to relieve symptoms and improve quality of life. Some large tumors, for example, may be removed to relieve pressure off internal organs. Chemotherapy or radiation therapy may also be used to shrink tumors to achieve the same ends. Another option, such as thoracentesis or paracentesis, may be used to remove fluid build-up that causes discomfort.

Additional information about mesothelioma and treatment options will be sent to interested patients and their loved ones who fill out the request form on this page.

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