The 4 Stages of Mesothelioma

Medically Reviewed by Dr. F. Perry Wilson

Understanding how mesothelioma is staged and progresses helps patients make informed decisions about treatment.

After receiving a mesothelioma diagnosis, patients and their families need clear, reliable information and someone who understands what they are going through. Our experienced mesothelioma lawyers are here to help you navigate through this difficult time.

How Pleural Mesothelioma Progresses

Pleural mesothelioma, which forms in the tissue surrounding the lungs and accounts for more than 80% of all mesothelioma diagnoses, is a rare cancer caused by asbestos exposure. Doctors classify the progression of pleural mesothelioma in four main stages. Understanding the stages of mesothelioma is vital for patients, their loved ones, and healthcare professionals involved in diagnosis and treatment.

The stages follow the TNM (tumor, node, metastasis) system, an international standard for classifying the amount and spread of cancer. As the disease progresses, it affects nearby tissues, structures, and organs, making treatment more challenging. In advanced stages, mesothelioma may spread to other organs and systems leading to a decline in prognosis.

Regardless of the stage or form of a mesothelioma diagnosis, patients or family members have a limited amount of time to pursue legal action due to time restrictions called statutes of limitations. Once you receive a diagnosis, it’s important to contact a specialized lawyer to ensure that you won’t lose your right to pursue compensation for your injury.

Mesothelioma Stage 1

The first stage of pleural mesothelioma is characterized by localized cancer growth in the lining of the lungs or affected areas. The tumor is confined, has not spread beyond its origin, and is relatively small. Symptoms may be mild or absent, making early detection challenging.

  • Localized tumor confined to one lung or affected area
  • Limited involvement of nearby lymph nodes or distant organs
  • Small tumor size
  • Asymptomatic or mild symptoms, such as chest discomfort, shortness of breath
  • Overlapping symptoms with other respiratory conditions, such as persistent cough
Treatment options:
  • Surgery to remove the tumor and affected tissues while preserving lung function
  • Adjuvant radiation therapy to target any remaining cancer cells
  • Systemic chemotherapy to eliminate microscopic cancer cells

The prognosis for stage 1 mesothelioma is relatively optimistic, with better chances of long-term survival. Consultation with a specialized healthcare team is crucial for developing an individualized treatment plan and maximizing outcomes.

Mesothelioma Stage 2

Stage 2 pleural mesothelioma represents a progression of the disease beyond its initial site, with cancer beginning to spread to nearby tissues and structures. While the cancer has advanced, it is still relatively contained within the affected area.

  • Localized spread to nearby structures like the diaphragm, chest wall, or lung
  • Limited involvement of nearby lymph nodes
  • Larger tumor size compared to stage 1, but still relatively localized
  • Persistent cough, attributed to the growing tumor's impact on the respiratory system
  • Chest discomfort or pain, which may radiate to other areas
  • Shortness of breath, particularly during physical exertion
  • Fatigue and reduced energy levels
Treatment options:
  • Surgery to remove the visible tumor and affected tissues while preserving lung function
  • Systemic chemotherapy to target and destroy cancer cells throughout the body
  • Adjuvant radiation therapy after surgery to minimize the risk of local recurrence

The outlook for stage 2 mesothelioma varies based on individual factors. Timely diagnosis and appropriate treatment are crucial for optimal outcomes.

Mesothelioma Stage 3

Stage 3 pleural mesothelioma represents a more advanced stage of the disease, with significant spread beyond the initial location.

  • Localized spread to nearby structures like the diaphragm, chest wall, or organs within chest cavity
  • Extensive involvement of lymph nodes near and far from the primary tumor site
  • Advanced disease progression
  • Persistent and intense chest pain due to the invasion of nearby structures and nerves
  • Increasing shortness of breath, impacting daily activities
  • Coughing, wheezing, and respiratory distress
  • Fatigue, reduced energy levels, and unintentional weight loss
Treatment options:
  • Palliative care to alleviate pain, manage symptoms, and improve quality of life
  • Chemotherapy to shrink the tumor, control cancer cell spread, and alleviate symptoms
  • Radiation therapy targeting specific tumor areas to relieve certain symptoms
  • Innovative treatment approaches through participation in research studies

Stage 3 carries a less favorable prognosis than earlier mesothelioma stages. Consulting with a healthcare team of mesothelioma specialists is vital for personalized treatment planning, effective symptom management, and supportive care to enhance quality of life.

Mesothelioma Stage 4

Stage 4 pleural mesothelioma represents the most advanced stage of the disease, indicating extensive spread of cancer within the chest cavity and potential metastasis to distant organs.

  • Extensive spread to nearby structures, organs, and tissues within the chest cavity
  • Distant metastasis to other areas of the body through the bloodstream or lymphatic system
  • Potential involvement of critical organs
  • Persistent and intense pain localized to the chest or other affected areas
  • Increasing breathing difficulties, even at rest
  • Severe weight loss, muscle atrophy, weakness, and a general decline in health
  • Accumulation of fluid in the chest cavity or abdomen, leading to discomfort and limitations in daily activities
Treatment options:
  • Palliative care to alleviate pain, manage symptoms, and improve quality of life
  • Chemotherapy to shrink the tumor and alleviate symptoms
  • Radiation therapy targeting specific tumor areas to relieve pain or discomfort
  • Comprehensive supportive care measures, including pain management, nutrition support, and psychological support

At stage 4, the focus of mesothelioma treatment shifts primarily to providing palliative care to alleviate symptoms and improve quality of life.

Other Mesothelioma Staging Systems

In addition to the TNM staging system, there are two other popular staging systems doctors use today. While each system varies slightly in terms of what is specifically being measured, each one uses four stages to classify how far the disease has progressed.

Butchart Staging System

The Butchart system measures the extent of the primary tumor and classifies the mesothelioma into one of four stages:

  • Stage I: Mesothelioma exists in either the right or left pleura. The lung, pericardium or diaphragm on the same side may also be involved.
  • Stage II: Mesothelioma may be present in the heart or both sides of the pleura and invades the chest wall or involves the esophagus. Lymph node involvement in the chest may also be present.
  • Stage III: Additional lymph nodes beyond the chest may be involved, and the mesothelioma has moved through the diaphragm and invaded the peritoneum.
  • Stage IV: The cancer has metastasized to other organs and the bloodstream.

Brigham Staging System

The Brigham Staging System defines whether surgery is a viable treatment option for a mesothelioma patient and whether there is lymph node involvement. It is similar to both the Butchart Staging System and the TNM Staging System in that it defines the progression of mesothelioma in four stages:

  • Stage I: Surgery is a possible treatment option in the first stage. The cancer hasn’t yet spread to lymph nodes, and tumors exist only in the lungs’ lining.
  • Stage II: Surgery is still an option in Stage II as the mesothelioma remains localized. Lymph node involvement is detected.
  • Stage III: Surgical intervention is no longer an option. The mesothelioma has spread into the chest wall, heart or through the diaphragm into the peritoneum. Lymph node involvement may or may not be present.
  • Stage IV: When diagnosed in Stage IV, a patient's prognosis is the least favorable. Mesothelioma has metastasized to other organs, and the cancer is pervasive in the body.

These staging systems provide doctors with information that allows them to accurately determine a patient's prognosis and assess therapeutic treatment options.

Other Types of Mesothelioma and Their Stages

While pleural mesothelioma is the most prevalent form of this cancer, there are three other types of mesothelioma. They are:

  • Peritoneal mesothelioma: Forms in the peritoneum, the lining of the abdomen, and comprises nearly 10% of all mesothelioma cases. Peritoneal mesothelioma commonly follows the four-stage peritoneal cancer index (PCI), which classifies the cancer by segmenting your abdomen into 13 sections and assigning each a number from 0 to 3.
  • Pericardial mesothelioma: Develops in the pericardium, the lining surrounding the heart, and makes up 0.2% of all new mesothelioma cases. As there’s no formal staging system specific to pericardial mesothelioma, it’s commonly classified into two stages — early and late.
  • Testicular mesothelioma: Originates in the lining of the tests and accounts for 0.2% of mesothelioma cases. As with pericardial mesothelioma, testicular mesothelioma is typically characterized as either early or late stage.

When Should You Consult a Lawyer?

If you or a family member has been diagnosed with mesothelioma, it's important to consult with a lawyer as soon as possible. An experienced mesothelioma lawyer can help you with:

  • Understanding Your Rights: A mesothelioma lawyer specializes in asbestos litigation and can help you understand your legal rights to compensation.
  • Securing Compensation: Mesothelioma can bring significant financial burdens. A qualified lawyer can help understand potential compensation options which may include bankruptcy trust funds and/or lawsuits against responsible parties that can result in verdicts or settlements.
  • Taking Timely Legal Action: Consulting a lawyer early allows them to help you gather information, initiate legal proceedings, build a strong case and ensure that your case is filed within the right timeframe. The time limit for filing an asbestos lawsuit is determined by time limits called statutes of limitations. Each state sets its own deadline for filing, making prompt action important.

Consulting a mesothelioma lawyer ensures you receive proper legal guidance and support, protects your rights, and maximizes the chances of a successful compensation claim.

For over 40 years, ELSM has been fighting hard on behalf of thousands of mesothelioma victims and their families nationwide. Our lawyers have extensive asbestos knowledge and will guide you through the legal process to help you secure the compensation you deserve.

Frequently Asked Questions

How quickly does mesothelioma progress?

The progression of mesothelioma can vary from person to person. In some cases, mesothelioma can progress rapidly, while in others, it may progress more slowly over a period of several months or even years.

How long can you live with mesothelioma by stage?

Generally, earlier stages of mesothelioma have a longer life expectancy compared to advanced stages. In stage 1 and stage 2 mesothelioma, where the cancer is localized or has limited spread, more treatment options are available and the prognosis is generally better. The prognosis for stage 4 mesothelioma is about 12 – 26 months. Individual health factors, treatment response, and the specific type of mesothelioma and location can also significantly impact life expectancy.

What happens in the final stages of mesothelioma?

In the final stages of mesothelioma, the disease has typically advanced, and symptoms often become more severe. These symptoms may include significant pain, difficulty breathing, fatigue, weight loss, and fluid buildup. Treatment at this stage primarily focuses on palliative care, which aims to alleviate pain, manage symptoms, and improve the individual's quality of life.

Request a Free Case Evaluation

Request a free case evaluation now if you or someone you love has been diagnosed with mesothelioma. The evaluation will cost you nothing. Our lawyers will travel to visit you at your convenience or conference call with you over the phone. We understand how difficult a time this is for you and will assist in any way that we can. You can also call us toll-free at 1-800-336-0086 at any time.

Dr. F. Perry Wilson Medically Reviewed by Dr. F. Perry Wilson

Dr. F. Perry Wilson is a board-certified physician. He serves as Associate Professor of Medicine at the Yale University School of Medicine and is the Interim Director at the Yale Program of Applied Translational Research. Dr. Wilson is a contributor on the editorial team and is responsible for ensuring that all medical content is accurate.