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Stage 2 Mesothelioma

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This page was medically reviewed by James Stevenson, M.D. on February 6, 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.

James Stevenson, M.D. Thoracic Medical Oncologist

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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. Overview

What Is Stage 2 Mesothelioma?

Stage 2 mesothelioma involves the spreading of cancer to nearby organs and tissues. At this stage, spreading is localized.

Stage 2 Mesothelioma Characteristics

  • Mesothelioma tumors develop in the lining of the organs (most often, the lining of the lungs)
  • Cancer metastasis (spreading) to nearby organs and tissues
  • No distant metastasis

Stage 2 mesothelioma is one of the early stages of the asbestos-related cancer. When they are diagnosed in the early stages, patients typically have more treatment options available. Early diagnoses and treatments result in more favorable prognoses, including longer life expectancies.

Staging of Mesothelioma

Mesothelioma staging varies by mesothelioma type. 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.

02. Stage 2 Symptoms

What Are the Symptoms of Stage 2 Mesothelioma?

Stage 2 mesothelioma symptoms may start mild but can worsen as the disease progresses. Symptoms vary depending on where in the body the cancer has formed. Due to the mild and varied nature of symptoms, early-stage mesothelioma is often misdiagnosed as more common conditions.

Stage 2 Mesothelioma Symptoms*

  • Abdominal pain
  • Chest pain
  • Chronic coughing
  • Shortness of breath (dyspnea)
  • Fever
  • Unexplained weight loss

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

If patients have symptoms they believe could be caused by mesothelioma, they should contact a physician right away. Investigating early symptoms, even minor ones, can lead to early detection and improved prognosis.

03. Stage 2 Types

Stage 2 Mesothelioma by Type

When diagnosing patients with malignant mesothelioma, doctors conduct a variety of imaging-based tests. The tests enable doctors to identify disease location and status.

Stage 2 Pleural Mesothelioma

Malignant pleural mesothelioma is the most common type of the cancer. Due to 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, number of affected lymph nodes and metastasis (spreading).

Stage 2 Pleural Mesothelioma 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. However, there is not a widely accepted peritoneal mesothelioma staging system. Mesothelioma doctors may use the Peritoneal Cancer Index (PCI). This staging system is used to stage a variety of abdominal cancers.

Using the PCI, doctors score regions of the abdomen based on number and size of tumors. The total score determines the stage.

Stage 2 Peritoneal Mesothelioma Characteristics

  • Stage 2 peritoneal cancer has a PCI score of 11 – 20.
  • The cancer may have metastasized (spread) to nearby organs, tissues and/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 1 – 2% of all mesothelioma diagnoses. Due to this rarity, pericardial mesothelioma does not have its own staging system. Doctors typically diagnose pericardial mesothelioma in later stages of the disease.

Stage 2 Testicular Mesothelioma

Less than 1% of all mesothelioma cases develop in the testicles. There is limited information about staging of testicular mesothelioma. However, studies show late-stage disease relates to poor survival.

04. Stage 2 Prognosis

Stage 2 Mesothelioma Prognosis

Patients diagnosed in stage 2 typically have a more favorable prognosis than those diagnosed in later stages of mesothelioma. In the early stages, the disease is still localized and can often be addressed with aggressive treatment, such as surgery.

Prognosis can be affected by a variety of factors, including patient age, gender, overall health, cancer type and cell type.

Factors Influencing Stage 2 Mesothelioma Prognosis

  • Tumor location: Stage 2 peritoneal mesothelioma and pleural mesothelioma typically have more favorable prognoses when compared to pericardial and testicular mesothelioma.
  • Cell type: Stage 2 epithelioid mesothelioma has a more favorable prognosis than stage 2 sarcomatoid or biphasic mesothelioma.
  • Patient age: Younger stage 2 mesothelioma patients often have a more favorable prognosis than older patients.
  • Overall health: Stage 2 patients with good overall health and no pre-existing conditions typically have a more favorable prognosis than those in poor health.

Stage 2 Mesothelioma Life Expectancy

Mesothelioma life expectancy is the estimate of how long patients will live with or without treatment. In addition to stage, other factors impact life expectancy, including mesothelioma type, cell type and gender. For early-stage mesothelioma life expectancy is difficult to measure, as patients often survive past the length of the study.

Stage 2 Mesothelioma Survival Rate

Mesothelioma studies typically gather survival statistics based on survival rates and median survival. Survival rate is the percentage of patients that survive for a given period of time following diagnosis. Mesothelioma survival rates are typically provided at the 2- and 5-year marks. Median survival is the time at which 50% of patients are still alive. These statistics give patients a good estimate of prognosis.

Stage 2 Pleural Mesothelioma Survival Statistics

  • The 2-year survival rate for stage 2 pleural mesothelioma is 39%.
  • The 5-year survival rate for stage 2 pleural mesothelioma is 9%.
  • The median survival for stage 2 pleural mesothelioma is 19 months (compared to 16 months for stage 3).

Stage 2 Peritoneal Mesothelioma Survival Statistics

  • The 2-year survival rate for stage 2 peritoneal mesothelioma is 64%.
  • The 5-year survival rate for stage 2 peritoneal mesothelioma is 53%.
  • The median survival for stage 2 peritoneal mesothelioma is 67 months (compared to 56 months for stage 3).

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

05. Can It Be Cured?

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 are typically healthier and better able to withstand aggressive treatments. In the early stages, surgical treatment can be more effective because the cancer is still localized. Through treatment, patients may outlive their prognosis by months or years.

Long-Term Survivorship After Stage 2 Mesothelioma Diagnosis

Heather Von St. James
  • 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 was treated with surgery, chemotherapy and radiation.
  • Heather is now a mesothelioma survivor of more than a decade.
Learn More About Heather

Mesothelioma researchers continue to test treatments for early- and late-stage mesothelioma patients.

06. Stage 2 Treatment

Stage 2 Mesothelioma Treatment

Mesothelioma treatment plans for stage 2 patients typically consist of a multimodal approach. Multimodal mesothelioma treatment commonly combines surgery, chemotherapy and/or radiation. However, multimodal treatments will differ by individual case.

In patients with no distant metastasis (spreading), physicians can often use aggressive therapies. These treatment plans attempt to remove as much of the cancer as possible. However, some stage 2 patients may have risk factors that limit their treatment options.

Stage 2 Mesothelioma Treatment Options

  • Surgery
  • Chemotherapy
  • Radiation Therapy
  • Clinical Trials

Surgery

For stage 2 patients, surgery attempts to remove as many areas affected by mesothelioma as possible. Patients diagnosed at this stage may undergo extrapleural pneumonectomy (EPP), pleurectomy with decortication (P/D) or peritoneal resections.

  • Extrapleural pneumonectomy (EPP) involves the removal of one lung and surrounding tissues.
  • Pleurectomy with decortication (P/D) involves the removal of the lung lining and cancerous tissue, without lung removal.
  • Peritoneal resections, such as peritonectomy, involve the removal of cancerous tissue from the abdominal cavity.

Chemotherapy

For stage 2 patients, chemotherapy is usually administered prior to a main treatment type (neoadjuvantly) or after the main therapy (adjuvantly). When used in one of these two ways, chemotherapy helps to kill cancer cells that may remain after surgery.

In the early stages of mesothelioma, peritoneal patients may be eligible for surgery combined with a heated chemotherapy wash, or HIPEC. This treatment modality has improved 5-year survival rates to approximately 50%.

Radiation Therapy

Radiation may be administered before or after surgery. This therapy prevents the spread or recurrence of mesothelioma cells following surgical procedures.

  • 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 2 patients treated with adjuvant radiation achieved 24-month survival.
  • Comparatively, 25% of stage 3 patients treated with adjuvant radiation achieved 24-month survival.

Clinical Trials

Stage 2 patients may be eligible for emerging treatments through clinical trials. Some patients experience extended life expectancies from emerging treatments, such as photodynamic therapy and immunotherapy.

Palliative treatments may also accompany standard therapies. Stage 2 patients may undergo these therapies to reduce mesothelioma cancer symptoms. Palliative care may also treat symptoms resulting from traditional therapies, such as chemotherapy.

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