Stage 2 Mesothelioma

Expert Fact Checked

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James Stevenson, M.D. Thoracic Medical Oncologist

In stage 2 mesothelioma, the cancer has spread to nearby organs and tissue. However, there is no distant spreading. Treatment options may be aggressive, typically consisting of surgery, chemotherapy and radiation. The median survival for stage 2 mesothelioma ranges from 19 to 67 months, depending on the type of mesothelioma.

01. Mesothelioma Stage 2 Overview

What Is Stage 2 Mesothelioma?

In stage 2 mesothelioma, the cancer has typically spread to nearby organs and tissues. Depending on the patient’s type of mesothelioma, different areas of the body may be affected. At this early stage, spreading is localized, and patients may experience few and mild symptoms. Stage 2 median overall survival is 19 – 67 months.

In early-stage diagnoses, like stage 2, patients typically have many mesothelioma treatment options, including aggressive therapeutic surgeries. Early diagnoses and treatments can result in more favorable prognoses. A more favorable prognosis may mean longer patient life expectancies.

Pleural mesothelioma is the only form with its own widely accepted staging system. Other forms of mesothelioma may be staged using more general cancer staging systems.

Staging of Mesothelioma

Mesothelioma is categorized into four stages. Early stages include stage 1 and stage 2. Stage 3 and stage 4 are considered later stages.

  • Stage 1: Tumor is localized to original location and has not spread.
  • Stage 2: Cancer begins to spread to nearby organs and tissues.
  • Stage 3: Cancer cells have spread to nearby organs, tissues and lymph nodes.
  • Stage 4: Cancer has spread to nearby and distant organs, tissues and lymph nodes.
02. Stage 2 Prognosis

Stage 2 Mesothelioma Prognosis

Stage 2 mesothelioma patients have a general life expectancy of 19 – 67 months. Patients diagnosed in stage 2 typically have a more favorable mesothelioma prognosis than those diagnosed later. In the early stages, the disease is still localized and can often be addressed with a range of treatment options and combinations.

Prognosis can be affected by a variety of factors.

Factors Influencing Stage 2 Mesothelioma Prognosis

  • Tumor location: Certain types of mesothelioma may have better prognoses than others.
  • Cell type: Some mesothelioma cell types respond better to treatments than others. As a result, these patients may experience a more favorable prognosis.
  • Patient age: Younger stage 2 mesothelioma patients often have a more favorable prognosis than older patients.
  • Overall health: Patients with good overall health and no pre-existing conditions typically have a more favorable prognosis than those in poor health. They may also be eligible for a wider range of treatment options.

Stage 2 Mesothelioma Life Expectancy

Stage 2 life expectancy with treatment ranges from 19 to 67 months, depending on the type of mesothelioma. Mesothelioma life expectancy is the estimate of how long patients will live with or without treatment. Many patients experience longer life expectancies with treatment.

Treatment options for stage 2 mesothelioma patients include aggressive surgeries and multimodal treatment combinations. Patients should speak with their care teams about their specific cases. Even patients diagnosed in later stages have gone on to outlive their initial prognoses by several years.

Stage 2 Mesothelioma Survival Rate

The stage 2 mesothelioma 1-year survival rate is 70% for pleural mesothelioma and 86% for peritoneal mesothelioma. Survival rates are generally better with treatment than without.

Survival rate is the percentage of patients who survive for a given period of time following diagnosis. Median survival is the time at which 50% of patients are still alive.

In one study, pleural mesothelioma patients underwent chemotherapy and then pleurectomy/decortication (P/D) surgery. Early-stage patients made up 71% of the study, which includes stage 1 and stage 2 patients. Some patients received extrapleural pneumonectomy (EPP) or follow-up chemotherapy, if necessary. Overall 1-year survival was 93% and 3-year survival was 65%.

Mesothelioma statistics, such as survival rate, come from studies. This data can provide doctors and patients with a better understanding of the disease. However, each diagnosis is unique. Patients should discuss their prognoses with their doctors.

Mesothelioma survival rates are typically provided at the 1-, 2- and 3-year marks. With improvements in research and treatment, 5-year mesothelioma statistics are becoming more common.

These statistics give patients a good estimate of prognosis.

Stage 2 Pleural Mesothelioma Survival Statistics

Researchers have reported the following survival rates for stage 2 patients who underwent treatment:

  • 2-year: 39%
  • 5-year: 9%
  • Median survival: 19 months (compared to 16 months for stage 3)

Stage 2 Peritoneal Mesothelioma Survival Statistics

Peritoneal mesothelioma patients often have the best survival statistics. Researchers have reported the following statistics for stage 2 patients who underwent treatment:

  • 3-year: 65%
  • 5-year: 52%
  • Median survival: 67 months (compared to 56 months for stage 3)
03. Is Stage 2 Mesothelioma Curable?

Can Stage 2 Mesothelioma Be Cured?

No stage of mesothelioma is considered curable. However, early-stage diagnosis offers the most favorable prognosis. If diagnosed in stage 1 or 2, patients may be healthier and better able to withstand aggressive treatments. Through treatment, patients may extend their life expectancy by months, years or even more than a decade. Mesothelioma researchers continue to test treatments for early- and late-stage mesothelioma patients.

Long-Term Survivorship After Stage 2 Mesothelioma Diagnosis

Long-term survivorship with mesothelioma is possible. Individuals diagnosed early have the best chance of extended survival. Newer treatments like immunotherapy present promise for longer-term mesothelioma survival. Mesothelioma researchers continue to test this and other treatments to improve outcomes.

Heather Von St. James: Survivor of Stage 2 Pleural Mesothelioma

Heather was diagnosed with mesothelioma in 2005. According to Dana-Farber Cancer Institute, she had stage 2 epithelioid pleural mesothelioma. Without treatment, Heather was told she had 15 months to live.

She underwent several rounds of treatment, receiving surgery, chemotherapy and radiation. Heather is now a mesothelioma survivor of more than 15 years.

04. Stage 2 Symptoms

What Are the Symptoms of Stage 2 Mesothelioma?

Stage 2 mesothelioma symptoms often start mild. As the disease progresses, mesothelioma symptoms may worsen or become more prominent. Symptoms vary depending on where in the body the cancer has formed.

Because of the mild and varied nature of symptoms, early-stage mesothelioma may be misdiagnosed as more common conditions. For example, pleural mesothelioma may be misdiagnosed as other lung conditions, such as lung cancer.

Stage 2 Mesothelioma Symptoms*

  • Abdominal pain
  • Chest pain
  • Chronic coughing
  • Fever
  • Fluid buildup (peritoneal or pleural effusion)
  • Shortness of breath (dyspnea)
  • Unexplained weight loss

*List is a combination of common pleural, peritoneal, pericardial and testicular symptoms

Patients with a known history of asbestos exposure should be especially sensitive to any changes in their bodies. If patients have symptoms they believe could be caused by mesothelioma, they should contact a physician right away. Investigating early symptoms, even minor ones, may lead to early detection and improved prognosis.

05. Stage 2 Diagnosis

Stage 2 Mesothelioma Diagnosis and Causes

Mesothelioma may present diagnosis difficulties, in part because of the long period between asbestos exposure and symptom onset. The only definitive way to diagnose mesothelioma is by testing a biopsy tissue sample. However, doctors will often perform other tests before a biopsy to rule out other diseases.

The diagnostic process often begins with an overview of the patient’s medical history. Patients with known asbestos contact should be sure to mention their exposure at this time. After that, doctors may conduct a physical exam to look for lumps, body changes and abnormalities. Then, doctors may order imaging scans and blood tests.

If these general tests do not rule out cancer, doctors may order a biopsy. A biopsy procedure removes fluid or tissue from the patient for testing. This testing can determine mesothelioma’s presence.

Why Is Stage 2 Mesothelioma Difficult to Diagnose?

All stages of mesothelioma can be difficult to diagnose. Early stages, like stage 2, may present even more of a challenge because the cancer is less developed and may not cause symptoms. Other reasons for diagnosis difficulty include:

  • Latency period: Mesothelioma can take 50 years or more to develop after asbestos exposure. This long latency period may cause people to forget their history of asbestos exposure. Without evidence of exposure, doctors may not immediately suspect mesothelioma, which can delay diagnosis.
  • Rarity: About 3,000 mesothelioma cases are diagnosed annually in the U.S. This rarity means some doctors may not recognize the disease at first or be equipped to diagnose it. For this reason, patients should seek a mesothelioma specialist for care.
  • Symptom presentation: Initial symptoms may be vague, mild or easily confused for other conditions.

Patients with known asbestos exposure can reduce the chance of misdiagnosis by mentioning their history to their doctor.

Asbestos Exposure and Mesothelioma

Asbestos exposure is the only known cause of mesothelioma. Individuals may be exposed at work, home or going about their daily lives. Occupational exposure is common in certain industries, such as construction, manufacturing and shipbuilding.

Individuals who develop mesothelioma may be eligible to receive compensation. Many mesothelioma patients were exposed through the fault of negligent companies. Mesothelioma lawyers can help patients receive the compensation they deserve for their illnesses. Contact an experienced mesothelioma attorney today to learn more about compensation options.

06. Stage 2 Types

Stage 2 Mesothelioma by Type

Each mesothelioma type has different stage 2 characteristics, associated prognoses and effective treatments.

Stage 2 Pleural Mesothelioma

Malignant pleural mesothelioma is the most common type of the cancer. It develops in the lining around the lungs, called the pleura. Because of its prevalence, there are three staging systems doctors may use to determine disease progression. These include:

Physicians most commonly use the TNM system to stage pleural mesothelioma. This system considers the size and extent of the tumor, the number of affected lymph nodes and metastasis (spreading).

Stage 2 Pleural Mesothelioma Characteristics

Stage 2 pleural mesothelioma has its own characteristics:

  • Mesothelioma tumors develop in the pleura (lung lining) but only on one side of the body.
  • Cancer cells may have spread into the adjacent lung, diaphragm and nearby lymph nodes.
  • There is no distant metastasis.

Stage 2 Peritoneal Mesothelioma

Peritoneal mesothelioma is the second most common form of the disease. It develops in the lining around the abdomen, called the peritoneum. Doctors do not have a staging system specific to peritoneal mesothelioma.

Mesothelioma doctors may use the Peritoneal Cancer Index (PCI) to estimate stage. This system is used to help stage a variety of abdominal cancers but is not a mesothelioma-specific staging system. Using the PCI, doctors score regions of the abdomen based on the number and size of tumors. The total score indicates the stage.

Stage 2 Peritoneal Mesothelioma Characteristics

Stage 2 peritoneal mesothelioma is characterized by little spread and a lower-end PCI score.

  • Stage 2 peritoneal cancer has a PCI score of 11 – 20.
  • The cancer may have spread to nearby organs, tissues or lymph nodes.
  • There is no involvement of distant organs.

Of the four main types of mesothelioma, peritoneal patients typically experience a more favorable prognosis. Early-stage diagnosis improves prognosis even further.

Stage 2 Pericardial Mesothelioma

Pericardial mesothelioma accounts for less than 1% of all mesothelioma diagnoses. This rare form develops in the lining around the heart, called the pericardium. Because it is rare, pericardial mesothelioma does not have its own staging system. Research into different characteristics of pericardial mesothelioma stages is limited. Doctors may not even stage this type.

Pericardial mesothelioma patients may still be eligible for certain treatments. Surgeries, multimodal treatments and palliative care may help improve pericardial mesothelioma prognosis.

Stage 2 Testicular Mesothelioma

Testicular mesothelioma develops in the tunica vaginalis, the lining around the testicle. Less than 1% of all mesothelioma cases develop in the tunica vaginalis. Information about staging of testicular mesothelioma is limited. However, doctors may be able to treat this rare disease to extend survival and improve quality of life.

07. Stage 2 Treatment

Stage 2 Mesothelioma Treatments

Stage 2 mesothelioma treatment plans typically take a multimodal approach. Multimodal mesothelioma treatment commonly combines surgery, chemotherapy, immunotherapy or radiation. Multimodal treatments differ by individual case and type of mesothelioma.

Mesothelioma doctors will consider the unique details of a patient’s case when putting together their treatment plan. It is important for patients to seek care from a doctor with lots of mesothelioma experience. An experienced doctor may ensure they are receiving the most effective treatments.

Stage 2 Treatment Costs

Treatment costs vary depending on a patient’s treatment plan, healthcare providers and insurance. However, financial assistance is available to help patients and loved ones cover mesothelioma medical expenses.

In stage 2 patients, physicians can often recommend aggressive therapies. These treatment plans attempt to remove as much of the cancer as possible. Palliative treatments may also accompany standard therapies. Stage 2 patients may seek palliative care to reduce mesothelioma cancer symptoms. Palliative care may also treat symptoms resulting from traditional therapies, such as chemotherapy.


For stage 2 patients, surgery attempts to remove as many mesothelioma tumors as possible. Patients diagnosed at this stage may undergo different surgeries for different types of mesothelioma.

Stage 2 pleural mesothelioma patients may receive extrapleural pneumonectomy (EPP) or pleurectomy with decortication (P/D). Stage 2 peritoneal mesothelioma patients may receive cytoreductive surgery (CRS) or a peritonectomy.

  • EPP removes the affected lung and surrounding tissues.
  • P/D removes the lung lining and cancerous tissue. It does not remove the affected lung.
  • CRS surgeries remove as much of the tumor as possible. Patients may hear CRS referred to as debulking or peritonectomy.


For stage 2 patients, chemotherapy can be administered before a main treatment type or after the main therapy. This helps to kill cancer cells.

In the early stages of mesothelioma, peritoneal patients may be eligible for surgery combined with heated intraperitoneal chemotherapy wash (HIPEC). This treatment has improved longer-term survival rates. In one study, stage 2 peritoneal mesothelioma patients treated with CRS and HIPEC experienced a 5-year survival rate of 62%. Some of these patients also received additional chemotherapy after CRS and HIPEC.


Immunotherapy uses a patient’s immune system to fight cancer. It has already helped extend survival for some mesothelioma patients. Different types of immunotherapy operate in different ways. Immunotherapy can be used as part of a multimodal treatment.

In one study, pleural mesothelioma patients of all stages received the immunotherapy duo Opdivo® and Yervoy®. The study compared this treatment to a chemotherapy regimen. Patients treated with Opdivo+Yervoy lived longer than those treated with chemotherapy.

The drug duo of Opdivo+Yervoy is a recommended treatment for some mesothelioma cases. Stage 1 and stage 2 patients may benefit from immunotherapy over chemotherapy.

Radiation Therapy

Radiation may be administered before or after surgery. This therapy helps decrease the spread or recurrence of mesothelioma cells following surgical procedures. It may be better suited to certain types of mesothelioma.

Studies have shown adjuvant radiation therapy may improve survival for patients with stage 1 and stage 2 pleural mesothelioma. One study from The University of Texas MD Anderson Cancer Center found more than 50% of stage 1 and 2 patients treated with adjuvant radiation lived at least two years.

Clinical Trials

Stage 2 patients may be eligible for emerging treatments through clinical trials. Some patients have benefitted from emerging treatments, such as photodynamic therapy and immunotherapy.

08. Common Questions

Common Questions About Stage 2 Mesothelioma

Is stage 2 mesothelioma curable?

Unfortunately, there is currently no cure for mesothelioma at any stage. However, early-stage patients often have the most favorable prognoses. Patients diagnosed in stage 2 or earlier are typically healthier and may be eligible for a wider range of treatments. For example, aggressive treatments like surgery can help patients achieve improved survival.

How long can you live with stage 2 mesothelioma?

The median survival for stage 2 mesothelioma ranges from 19 to 67 months. This range encompasses different types of mesothelioma. Doctors may be able to help patients live longer with treatment. Treatment options may be aggressive, typically consisting of surgery, chemotherapy and radiation. Some stage 2 patients have outlived their initial prognoses by several years.

Is stage 2 mesothelioma difficult to diagnose?

Mesothelioma can be difficult to diagnose in its early stages because symptoms may be unnoticed, mild or easily explained away by other conditions. In some cases, mesothelioma may even be misdiagnosed as other illnesses or forms of cancer. To receive an accurate diagnosis, patients should see a mesothelioma doctor with experience around this rare cancer.