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Understanding Mesothelioma Staging
Mesothelioma staging helps specialists understand how far a cancer has spread and guides treatment decisions. The earlier the stage, the more treatment options are available, often leading to better outcomes and improved life expectancy.
Pleural mesothelioma, the most common type, is staged using the four stage TNM system. In Stage 1, the cancer remains in its original location (localized), while in Stage 4, it has spread extensively to other areas (advanced).
Peritoneal mesothelioma does not have a standard staging system, but some specialists will assess tumor spread using the Peritoneal Cancer Index (PCI) to determine available treatment options.
While staging provides important information, it does not determine an exact prognosis for a patient. Many factors including treatment and overall health can help survival.
Better Understand Mesothelioma Stages
“If you're diagnosed with mesothelioma, move on it, and do it immediately, because it's important. We don't know how much time we have.”
Steve, Pleural Mesothelioma Patient & Resource Recipient
20+ Years of helping mesothelioma patients and their loved ones
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How Mesothelioma Is Treated
Mesothelioma treatment options are tailored to each patient’s unique diagnosis, focusing on improving outcomes, managing symptoms, and enhancing quality of life. Mesothelioma treatment can include:
Surgery
Palliative procedures
Radiation therapy
Chemotherapy
Immunotherapy
Targeted Therapy
Multimodal Therapy
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How Staging Affects Treatment Options
Mesothelioma stages help determine which treatments are available:
• Early stages (1 & 2) for pleural mesothelioma: Surgery, chemotherapy, immunotherapy, and radiation may be used to remove or slow tumor growth. Patients diagnosed at these stages often have the best survival chances.
• Advanced stages (3 & 4) for pleural mesothelioma: Treatment focuses on slowing the cancer’s progression and relieving symptoms. While surgery may not always be possible, chemotherapy, immunotherapy, and clinical trials can still help.
• Peritoneal mesothelioma treatment depends on PCI score rather than formal stages, but HIPEC treatment has greatly improved survival outcomes.
New treatments including targeted therapy and immunotherapy are improving outcomes at all stages, offering patients and families more options than ever before
Learn about the best treatment options for your stage
“It’s a good thing I didn’t wait and I jumped right on it, because you wait and you’re just getting sicker.”
Robert, Pleural Mesothelioma Patient and Resource Recipient in California
Long-Term
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7 Answers to Common Mesothelioma Stages Questions
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Peritoneal Mesothelioma Staging
Peritoneal mesothelioma does not a formal four-stage system. Instead, specialists commonly use the Peritoneal Cancer Index (PCI) to assess cancer spread within the abdominal cavity:
• PCI Score 1-10: Cancer is limited to a small area, and surgery with HIPEC (heated chemotherapy) is often highly effective.
• PCI Score 11-20: Cancer has spread more widely, but surgery may still be an option, often combined with other treatments.effective.
• PCI Score 21-39: Extensive tumor spread makes surgery more difficult, and treatment often focuses on slowing progression and managing symptoms.
Because peritoneal mesothelioma responds well to cytoreductive surgery with HIPEC, many patients live far beyond initial expectations, with 65% of peritoneal patients surviving 5 years or longer.
“When they tell you: you have cancer, everything changes. They gave me hope.”
Robert, Mesothelioma Patient & Resource Recipient in Florida
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How Malignant Mesothelioma Is Treated
Mesothelioma treatment options are tailored to each patient’s unique diagnosis, focusing on improving outcomes, managing symptoms, and enhancing quality of life. Mesothelioma treatment can include:
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• T (Tumor): Size and spread of the tumor in the chest
• N (Nodes): Whether the cancer has spread to nearby lymph nodes
• M (Metastasis): If the cancer has spread to distant parts of the body
Doctors use this system to help decide on the best treatment options available.
If needed, a biopsy (removing a small sample of tissue) will be used to confirm the diagnosis and help determine the stage.
If you or a loved one has been diagnosed with mesothelioma, it’s important to seek expert guidance as soon as possible. Earlier stage diagnosis offers a wider range of treatment options.
It’s important to act quickly regardless of which stage you or a loved one is at.
Stage 1: Around 21+ months
Stage 2: Around 19 months
Stage 3: Around 16 months
Stage 4: 12 months or less
For peritoneal mesothelioma, survival is often 5 years or longer with surgery and HIPEC.
Please note: These are only averages based on past diagnoses. Advancements in treatment, clinical trials, and personalized care are improving survival outcomes for newly diagnosed patients.
Patients with earlier stages may qualify for more aggressive treatments, while those in advanced stages might access new therapies more focused on improving quality of life.
Many patients live much longer than expected, especially with early treatment, new therapies, and personalized care.
Some patients have survived 10+ years after being diagnosed. Every diagnosis is unique and new treatments continue to improve outcomes.
Stages Information and Trusted Resources for Families Fighting Mesothelioma
Reminder: About 30% of All Mesothelioma Patients Are Veterans
Access resources and support set aside exclusively for mesothelioma patients who served our country:
Limited availability for December resources
"60 years ago I was exposed to asbestos in the Navy."
John, Pleural Mesothelioma Patient in Florida, Navy Veteran
The 4 Stages of Pleural Mesothelioma
The TNM four-stage system used for pleural mesothelioma helps determine how far the cancer has spread and supports personalized care decisions.
While early detection for pleural mesothelioma offers the best chance for treatment and improved outcomes, action can be taken at any stage:
"My husband Marty had mesothelioma long before he was diagnosed and he was stage 4."
Marge, Wife of Pleural Mesothelioma Patient Marty
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