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Stage 2 Mesothelioma

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This page was medically reviewed by Dr. James Stevenson, M.D. on March 19, 2019. For information on our content creation and review process read our editorial guidelines. If you notice an error or have comments or questions on our content please contact us.

Dr. James Stevenson, M.D. Thoracic Medical Oncologist

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HomeMesotheliomaStagesStage 2 Mesothelioma

Dr. James Stevenson, M.D.

Stage 2 mesothelioma indicates that the cancer has spread to nearby organs and tissues, but with no distant metastasis. Treatment options may be aggressive, typically consisting of surgery, chemotherapy and radiation. Patients generally face a life expectancy of 19 months or less.

Using the four-tier staging system for malignant mesothelioma, stage 2 is considered an early stage with mild symptoms that may increase in severity as the disease progresses. At this stage, the cancer is still localized, despite nearby spreading and possible lymph node involvement.


Stage 2 Mesothelioma by Type

When diagnosing patients with malignant mesothelioma, specialists will conduct a variety of image tests, like X-rays, MRI scans and CT scans to identify the disease location and progression. Prognosis varies for pleural, peritoneal, pericardial and testicular mesothelioma, especially if the cancer is caught in the early stages.

Stage 2 Pleural Mesothelioma

Malignant pleural mesothelioma is the most common type of the cancer with three staging systems that specialists use to determine disease progression, including the TNM system, Brigham system and Butchart system. The TNM system is most commonly used, looking at the size and extent of the tumor, number of affected lymph nodes and metastasis.

Stage 2 malignant pleural mesothelioma is categorized by tumor development in the pleura, but just on one side of the body. Cancer cells may have spread into the adjacent lung and diaphragm and nearby lymph nodes, but there is no distant metastasis.

According to the American Cancer Society, stage 2 malignant pleural mesothelioma has a 2-year survival rate of around 38% and a 5-year survival rate of around 10%.

Stage 2 Peritoneal Mesothelioma

With limited cases, peritoneal mesothelioma does not have its own staging system. Mesothelioma specialists generally use broad characteristics to classify the disease, though they may also use the Peritoneal Cancer Index (PCI), which stages abdominal cancers.

The PCI scores tumors based on number and size in distinct regions of the abdomen. These scores are then added up, and the total is used to determine stage. Stage 2 peritoneal cancer is classified by a score of 11 – 20.

Stage 2 peritoneal mesothelioma patients typically see metastasis to nearby organs and tissues, as well as to the lymph nodes. The disease is still considered to be localized with no involvement of distant organs. Of the four main types of mesothelioma, peritoneal patients typically experience a more favorable prognosis, especially during the early stages.

Stage 2 Pericardial Mesothelioma

Pericardial mesothelioma also doesn’t have its own ranking system due to its rarity. The limited number of cases that do exist are typically diagnosed in the late stages or posthumously. Based on staging for the other types, stage 2 pericardial mesothelioma indicates tumors that have developed in the pericardium and there may be nearby spreading, though there is no distant metastasis.

Due to the aggressive nature of pericardial mesothelioma, the disease may progress quickly with more severe symptoms even at earlier stages.

Stage 2 Testicular Mesothelioma

Only around 1% of all mesothelioma diagnoses develop in the testicles, leaving limited information regarding staging of the disease. Based on general cancer staging characteristics, stage 2 testicular mesothelioma has developed in the tunica vaginalis with nearby spreading, but no distant metastasis. Surgeries may be aggressive during the early stages, but testicular mesothelioma does have a high recurrence rate, requiring frequent monitoring.

Stage 2 Mesothelioma Symptoms

Stage 2 mesothelioma symptoms may not be severe but can worsen as the disease progresses. If patients suspect symptoms, even minor, they should contact a physician right away. Early detection is the best way to achieve a favorable prognosis.

Common Symptoms of Stage 2 Mesothelioma
  • Shortness of breath (dyspnea)
  • Chronic coughing
  • Chest or abdominal pains
  • Unexplained weight loss
  • Fever

Prognosis for Stage 2 Mesothelioma

Prognosis for stage 2 mesothelioma patients is more favorable than later stages as the disease is still localized and can often still be addressed with aggressive treatment techniques. Patients typically have a life expectancy of 19 months or less, with around 10% of mesothelioma patients surviving more than five years. Survival rates have improved in recent years with new diagnostic tools that help with early diagnoses and improved treatment methods.

Mesothelioma statistics are based on case studies of many patients and can provide both doctors and patients with a better understanding of the disease. However, each diagnosis is different, and prognosis can be affected by a variety of factors, including patient age, gender, cancer type, cell type and overall health.

Stage 2 Mesothelioma Treatment

Mesothelioma treatment plans for stage 2 patients typically consist of a multimodal approach, combining surgery, chemotherapy and radiation. With no distant metastasis, treatments can usually be aggressive to remove as much of the cancer as possible, but patient health or other risk factors may limit options.

  • Surgery: Surgery includes an attempt to remove the tumor, such as extrapleural pneumonectomy (EPP) or pleurectomy with decortication (P/D) or peritoneal resections.
  • Chemotherapy: Chemotherapy is usually administered as a neoadjuvant or adjuvant treatment to help kill cancer cells not removed by surgery. In early stages of mesothelioma, peritoneal patients may be eligible for surgery combined with a heated chemotherapy wash or HIPEC, which has improved 5-year survival rates to at least 50%.
  • Radiation: Radiation can be given before or after surgery to help prevent the spread or recurrence of mesothelioma cells.

Stage 2 patients may be eligible for emerging treatments and clinical trials. Some patients that have undergone clinical trials have seen extended life expectancies from treatments like photodynamic therapy. Palliative treatments may also accompany standard treatments to help reduce mesothelioma cancer symptoms or treat symptoms resulting from surgery, chemotherapy and radiation therapy.

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