Mesothelioma Stages
There are four mesothelioma stages. Stage 1 is the least advanced and easiest to treat while stage 4 is widespread. Though early-stage mesothelioma patients often live longer, treatment can help at every stage. Our nurses can connect you with top doctors and treatments for any stage of mesothelioma.
What Are the Stages of Mesothelioma?
The stages of mesothelioma cancer are:
- Stage 1: Cancer is in only the lung lining
- Stage 2: Tumors reach more tissues and lymph nodes
- Stage 3: Cancer spreads out of the chest to nearby organs
- Stage 4: Tumors have spread throughout the body
Stage allows doctors to measure how far cancer has spread. Mesothelioma staging greatly affects a patient’s overall prognosis (health outlook) and which treatments they can receive.
Oncologists (cancer doctors) can determine your mesothelioma cancer stage and recommend a treatment plan that best suits your needs.
Speak with our mesothelioma nurses now for help connecting with skilled doctors and the right treatments for any stage of this cancer.
- Find Top Doctors and Treatments
- Connect You With Clinical Trials
- Answer Medical Questions
Amy Fair
20+ Years Helping
Mesothelioma Patients
Pleural Mesothelioma Stages
Malignant pleural mesothelioma forms in the pleura (the lining of the lungs) and accounts for more than 75% of all cases, according to the American Cancer Society (ACS). It’s the only type with official stages.
Learn about each of the 4 pleural mesothelioma stages below.
In cases of stage 1 pleural mesothelioma, tumors are found in the pleura on one side of the chest wall.
There are two substages based on cancer spread:
- Stage 1A: Mesothelioma tumors have grown into the diaphragm (muscle at the bottom of the chest that helps with breathing) or a lung.
- Stage 1B: Tumors are in the mediastinum (space between the lungs), layers of the chest wall, or the pericardium (heart lining).
Doctors can often effectively treat mesothelioma stage 1 by removing the cancer tumors using surgery.
Stage 2 pleural mesothelioma is very similar to stage 1. The main difference is that the cancer has reached nearby lymph nodes.
The lymph system filters out toxins from the body, but cancer cells can use it to spread to new areas. This spread is called metastasis. Thankfully, mesothelioma stage 2 can still be treated through surgery and other options.
In the third stage of pleural mesothelioma, the cancer has had time to spread to other parts of the body outside of the chest — including to major organs.
By mesothelioma stage 3, the cancer has spread to other parts of the body outside of the chest. Many patients develop symptoms like chest pain at this stage.
There are two substages:
- Stage 3A: Cancer tumors reach the mediastinum, chest wall, pericardium, and nearby lymph nodes on one or both sides of the body. Surgery might still be an option.
- Stage 3B: Mesothelioma tumors spread into the esophagus, heart, abdominal lining, spine, or the other side of the chest wall. Doctors cannot safely perform surgery, but other options may help you live longer.
Doctors can determine which treatments will work best if you have stage 3 pleural mesothelioma.
Stage 4 pleural mesothelioma is the most advanced stage. Mesothelioma tumors have reached distant parts of the body, making them hard to treat.
Stage 4 mesothelioma can spread to the:
- Adrenal glands
- Bones
- Kidney
- Liver
- Spinal column
- Other body parts
While this cancer is very aggressive, you could still become a mesothelioma stage 4 survivor. The best way to work toward survivorship is to get treatment.
Call (877) 446-5767 now to explore potential treatments that could help you live longer at any mesothelioma stage.
Staging for Other Types of Mesothelioma
None of the other types of mesothelioma have official stages since they’re a lot less common. That said, doctors can still assess how far these cancers have spread.
Peritoneal Mesothelioma Stages
Peritoneal mesothelioma forms in the lining of the abdominal cavity (peritoneum).
Doctors use two unofficial stages for this cancer:
- Localized peritoneal mesothelioma: Cancer is only in the abdomen lining or nearby tissues.
- Advanced peritoneal mesothelioma: Tumors have spread to organs like the liver, spleen, uterus, or ovaries.
Doctors can recommend a treatment plan based on the spread to give you the best chance of living longer.
Pericardial & Testicular Mesothelioma Stages
Pericardial and testicular mesothelioma are both very rare, with a few hundred cases reported, so they’re informally staged like peritoneal mesothelioma.
Here is how these cancers spread:
- Pericardial mesothelioma forms in the pericardium. In advanced stages, it can reach the kidneys, liver, or lungs.
- Testicular mesothelioma develops in the lining of the testicles. It may spread to distant organs like the lungs and lymph nodes near the peritoneum.
Speak with our registered nurses now for help finding and affording medical care for any type and stage of mesothelioma.
- Find Top Doctors and Treatments
- Connect You With Clinical Trials
- Answer Medical Questions
Amy Fair
20+ Years Helping
Mesothelioma Patients
Diagnosing Mesothelioma Stages
If mesothelioma is suspected, doctors will take note of your symptoms and if you were ever exposed to asbestos, the only known cause of this cancer. Then, they can order tests to confirm the mesothelioma diagnosis and assess your stage.
Tests used to diagnose mesothelioma cancer stages include:
- Imaging tests: X-rays, PET scans, and CT scans can help doctors look inside the body for possible cancer tumors and see how far they’ve spread.
- Blood tests: These allow doctors to detect mesothelioma biomarkers (substances that could mean you have cancer).
- Biopsies: Doctors extract a sample of fluid or tissue from an area that might be cancerous. A pathologist examines the sample under a microscope and determines whether cancer cells are present. This is the only way to confirm a diagnosis.
Most mesothelioma cases aren’t diagnosed until stage 3 or 4, as symptoms usually don’t appear until these later stages.
Once you’ve been diagnosed, your doctors can recommend a treatment plan based on your mesothelioma stage, overall health, and other factors.
Treatment for Mesothelioma By Stage
What stage of mesothelioma you have can greatly impact which cancer treatments you qualify for. View treatments for mesothelioma by stage and learn how they can help you live longer.
![]()
Stage 1 Mesothelioma Treatments
Stage 1 Mesothelioma TreatmentsPatients with stage 1 mesothelioma have the most treatment options available. Doctors typically treat early-stage mesothelioma with surgery to remove tumors.
Major surgeries for stage 1 mesothelioma include:
- Extrapleural pneumonectomy (EPP): Doctors remove all of the cancer tumors they can see from the lung and chest cavities, along with the pleura and the lung closest to the cancer.
- Pleurectomy with decortication (P/D): An alternative to the EPP, doctors take out the cancer tumors and the pleura, but a lung isn’t removed, so patients can recover faster.
Other treatments like chemotherapy and radiation therapy can shrink tumors before surgery or kill cancer cells left behind after one.
Patients with localized peritoneal, pericardial, or testicular mesothelioma may also qualify for surgeries. The most notable is cytoreductive surgery with heated chemotherapy (HIPEC) for peritoneal mesothelioma, which can greatly improve survival.
![]()
Stage 2 Mesothelioma Treatments
Stage 2 Mesothelioma TreatmentsStage 2 mesothelioma patients can receive the same treatments as stage 1 patients, including surgeries, chemotherapy, immunotherapy, and radiation.
While the cancer has started to spread in this stage, doctors can often remove or destroy all visible tumors.
![]()
Stage 3 Mesothelioma Treatments
Stage 3 Mesothelioma TreatmentsMesothelioma stage 3 can start to reach other parts of the body. If the cancer has spread too far, doctors can’t remove all the tumors through surgery.
That said, other therapies like chemotherapy, immunotherapy, and radiation can destroy tumors in the chest cavity and nearby organs.
![]()
Stage 4 Mesothelioma Treatments
Stage 4 Mesothelioma TreatmentsSince stage 4 mesothelioma is the most advanced, doctors typically can’t use surgery. However, chemotherapy, immunotherapy, and radiation could all help stage 4 patients live longer.
Stage 4 mesothelioma patient John Stahl celebrated 5 years of survivorship in 2024 following successful chemotherapy treatments.
Patients who don’t wish to undergo major treatments may get palliative (pain-relieving) care to improve their quality of life. They could also seek out new treatments through clinical trials if their cancer doesn’t respond to standard ones.
Speak to a mesothelioma nurse now to learn which treatments may work best for your cancer stage.
- Find Top Doctors and Treatments
- Connect You With Clinical Trials
- Answer Medical Questions
Amy Fair
20+ Years Helping
Mesothelioma Patients
Prognosis of Mesothelioma Stages
Generally speaking, earlier stages have a better mesothelioma prognosis (overall health outlook) since they’re more easily treated.
Prognosis is measured using life expectancy (average amount of time someone lives after diagnosis) and survival rates (percent of patients still living after a set amount of time). View survival rates and life expectancy figures by stage below.
| Mesothelioma Stage | Life Expectancy | 5-Year Survival Rate |
|---|---|---|
| Stage 1 | 19.2 months | 11% |
| Stage 2 | 19.2 months | 11% |
| Stage 3 | 18.9 months | 13% |
| Stage 4 | 13.1 months | 11% |
The data above didn’t note a difference in long-term survival for stage 1 or 2 mesothelioma patients.
Mesothelioma Staging Systems
Doctors determine mesothelioma stage using a series of guidelines called a staging system. The most commonly used one is the Tumor-Node-Metastasis (TNM) staging system.
TNM Staging System
The TNM system assigns number values to three factors to determine the cancer stage. Higher numbers indicate a later stage of mesothelioma.
The TNM has three components to assign stages:
- Tumor size (T): How big are the mesothelioma tumors? Have they spread into nearby body parts?
- Node (N): Has the cancer spread to lymph nodes?
- Metastasis (M): Has the cancer metastasized to distant organs? If so, it’s automatically considered to be stage 4, according to the ACS.
Leading cancer publications, like the American Joint Committee on Cancer (AJCC) and the ACS, currently use the TNM system.
Other Staging Systems
Several mesothelioma staging systems were once used, but most fell out of favor once the TNM system was adopted.
These staging systems included:
- Brigham staging system: This assigned four stages of mesothelioma, but was deemed inferior to the TNM system.
- Butchart staging system: Like the Brigham system, this system classified mesothelioma into 4 stages, but doctors now believe the TNM system is more comprehensive and accurate.
- EOD coding system: Created by the Surveillance, Epidemiology, and End Results (SEER) program, doctors give a 10-digit code to a patient based on factors like tumor size and lymph node spread.
- Summary staging system: Also created by SEER, this system assigns a tumor one of five stages. Summary and EOD coding systems are occasionally used to stage mesothelioma, but the TNM system is preferred.
The International Association for the Study of Lung Cancer (IASLC) also periodically reviews and updates the TNM system based on new research findings.
Help for Any Mesothelioma Stage
No matter which mesothelioma stage you’re diagnosed in, it’s possible to become a long-term survivor. You or a loved one can work with mesothelioma doctors to get treatments for any stage, which could allow you to live longer.
Lung Cancer Group is committed to helping patients with mesothelioma get the care they need to survive this cancer.
Our registered nurses can:
- Connect you with top doctors
- Help you explore potential treatments
- Recommend compensation options for expenses
- Locate support groups and other resources near you
Call (877) 446-5767 or speak with our mesothelioma nurses now to learn more about how we can assist you.
Mesothelioma Stages FAQs
How many stages of mesothelioma are there?
There are four stages of pleural mesothelioma, with stage 1 being the least advanced and stage 4 being widespread. Other types of mesothelioma are informally staged as “localized” or “advanced.”
No matter which stage you’re in, mesothelioma treatments may help you live longer.
What is the end stage of mesothelioma?
Stage 4 mesothelioma is considered the end stage. However, while this was once considered to be a mesothelioma death stage, treatments are allowing more and more patients to live longer.
For example, a stage 4 mesothelioma patient is still alive 5 years after his diagnosis thanks to chemotherapy.
Contact us now to speak with a registered nurse about available treatment options if you have end-stage mesothelioma.
What is the prognosis for stage 3 mesothelioma?
The prognosis for stage 3 mesothelioma depends on which treatments you receive. Stage 3 patients who get surgery typically live for 18.9 months on average.
Top doctors can determine how mesothelioma stages impact life expectancy and overall survival and recommend a treatment plan to best suit your needs.
What is the survival rate for stage 4 mesothelioma?
Stage 4 mesothelioma cancer has a 5-year survival rate of 11%, according to a review of statistics from the National Cancer Database (NCDB). However, you or a loved one could survive stage 4 mesothelioma with the right treatments.
Call (877) 446-5767 to speak with mesothelioma nurses about treatments for your cancer stage.
How long are the final stages of mesothelioma?
The last stages of mesothelioma can span anywhere from several months to many years, depending on the treatments you receive and how your cancer responds to them.
You can live much longer in the final mesothelioma stages if doctors can shrink or remove your cancer tumors.
