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Staging is the process of finding out how far the cancer has spread. Staging is based on the results of the physical exam, biopsies, and other tests which are described in the section, “How is malignant mesothelioma found?” This is very important because your treatment and the outlook for your recovery depend on the stage of your cancer.

At this time, there is a formal staging system only for mesothelioma around the lung (pleural mesothelioma), the most common type. The AJCC (American Joint Committee on Cancer) staging system uses Roman numerals from I to IV (1 to 4) for the different stages. As a rule, the lower the number, the less the cancer has spread. A higher number, such as stage IV, means a more advanced cancer.

After looking at your test results, the doctor will tell you the stage of your cancer. Be sure to ask your doctor to explain your stage in a way you understand. This will help you decide on the best treatment for you.

Resectable versus unresectable cancer

To help decide about treatment, doctors often group mesotheliomas based on whether or not it is likely that the cancer can be removed by surgery. If it can be removed it is called resectable. If it cannot be removed it is unresectable. Whether or not the cancer can be removed is based not only on the size of the tumor and how far it has spread, but also on the mesothelioma subtype, where the tumor is, and whether the person is healthy enough to have surgery.

Even if the cancer can be removed, in most cases there are cancer cells that cannot be seen and that are left behind after surgery. For this reason, many doctors use other forms of treatment (like radiation therapy and/or chemotherapy) along with surgery when possible.

Other factors that affect outlook

While the stage of this cancer is important in looking at a person’s chances for survival, other factors should also be taken into account. Some that point to a better outlook include:

  • Being able to carry out normal tasks of daily life
  • Younger age
  • Epithelioid subtype
  • Not having chest pain
  • Not too much weight loss
  • Normal levels of a substance in the blood called LDH
  • Normal red blood cell counts, white blood cell counts, and blood platelet counts


Last Medical Review: 10/02/2012
Last Revised: 10/02/2012