Stage 2 Mesothelioma

What Is Stage 2 Mesothelioma?

Stage 2 pleural mesothelioma means your cancer has spread outside the original location where it first developed. Tumors spread in deep tissue near the original site and may invade your nearby lymph nodes, such as hilar lymph nodes. These lymph nodes, also known as N1 lymph nodes, are located at the root of your lung. 

The main difference between stage 2 and stage 1 pleural mesothelioma is tumor cells in your hilar lymph nodes. In stage 1, cancer cells haven’t yet reached any lymph nodes. Tumors in stage 2 may or may not have grown into your diaphragm or lung tissue. If you’re in otherwise good health, you may be eligible for an aggressive treatment plan in stage 2.

“The stages of the disease progress from stage 1 to stage 4. Stages 1 and 2 are considered early-stage mesothelioma,” explains Sean Marchese, registered nurse and oncology writer at The Mesothelioma Center.

Peritoneal mesothelioma has no formal staging system. Doctors often define this type of mesothelioma as stage 2 if there is local tumor growth involving the lymph nodes.

In stage 1, cancer cells have not yet reached any lymph nodes. Tumors in stage 2 may or may not have grown into the diaphragm or the lung tissue. Stage 2 mesothelioma patients who are otherwise healthy may be able to endure an aggressive treatment plan.

Stage 2 Mesothelioma Symptoms

In most cases, mesothelioma cancer symptoms aren’t present in stage 2. When people do notice symptoms, they’re typically minor. Symptoms may be mistaken as signs of a less severe illness such as flu, pneumonia or bronchitis.

Tumor growth or a fluid buildup in the pleura may cause pain and other symptoms as the lungs constrict. These symptoms become more frequent with stage 3 or stage 4 disease.

Symptoms of Stage 2 Mesothelioma

• Abdominal pressure or pain
• Chest pressure or pain
• Dry or persistent cough
• Fever or night sweats
• Nausea or vomiting
• Trouble breathing
• Unexplained weight loss

“So the symptoms of mesothelioma vary greatly from the time of the initial presentation until we see the patients,” Dr. Marcelo DaSilva, chief of thoracic surgery and medical director at AdventHealth Cancer Institute, tells us. “Most commonly, the patients present with cough, shortness of breath, difficulty in walking, loss of stamina.” 

Why Is Stage 2 Mesothelioma Difficult to Diagnose?

Stage 2 mesothelioma is challenging to diagnose because it has a long latency period. Decades pass between initial asbestos exposure and cancer development. Once tumors develop, they can multiply without causing symptoms until stages 3 or 4.

Doctors most often diagnose mesothelioma cases after the cancer has already spread beyond stage 2. The Mesothelioma Center’s 2025 patient survey found 8% of respondents were diagnosed with stage 2 mesothelioma. While only 22% of respondents in our survey were diagnosed with stage 1 or 2 mesothelioma (early stage), 50% were diagnosed with stage 3 or 4 (late stage).  

Life Expectancy for Stage 2 Mesothelioma

Median life expectancy for stage 2 mesothelioma patients is 1 to 2 years. About 38% of stage 2 mesothelioma patients survive for at least 2 years, and 11% live for 5 years or more. Survival rates underscore the seriousness of this diagnosis, but they can’t predict the outcome for an individual.

Each mesothelioma survivor’s life expectancy depends on many factors. Their overall health and the specific cancer cell type are essential in determining treatment options and effectiveness. People with stage 2 peritoneal mesothelioma tend to have better survival rates than those with pleural disease.

Stage 2 Mesothelioma Treatments

Stage 2 mesothelioma treatment options include chemotherapy, immunotherapy, surgery and radiation. Doctors also use multimodal therapy, which is a combination of treatments. The best combination of treatments will differ for each patient. 

“In some cases, we’ll provide the patients with an option for immunotherapy, although reserved for a few patients,” Dr. DaSilva shares with us. “We can also provide palliative surgery for patients in which they can get relief of their symptoms and then be treated in a multimodality, multispecialty protocol.”

Treating Stage 2 Mesothelioma

• Chemotherapy: Combining chemo drugs Alimta (pemetrexed) and cisplatin or carboplatin is the most common pleural mesothelioma treatment. For stage 2 peritoneal mesothelioma, chemo can be circulated throughout the abdominal cavity during surgery.
• Immunotherapy: Many people with stage 2 mesothelioma qualify for immunotherapies like checkpoint inhibitors. Keytruda (pembrolizumab), Opvido (nivolumab) and Yervoy (ipilimumab) use the body’s own immune system to kill mesothelioma cells.
• Radiation: It can shrink tumors before surgery or prevent local recurrence after surgery. Palliative radiation therapy can ease symptoms and improve quality of life.
• Surgery: The 2 main surgical options for pleural mesothelioma are extrapleural pneumonectomy and pleurectomy with decortication. A patient’s overall health and mesothelioma type determine which options doctors choose.

A study published in MDPI in 2022 of pleural mesothelioma patients at stages 1 and 2 found multimodal therapy safe and effective at improving survival. Participants underwent induction chemo, surgery, postoperative radiation therapy and chemo.

Researchers reported a median overall survival of 32.1 months. That figure surpassed the average 12-month survival. Clinical trials also offer experimental treatments such as immunotherapy.

Is Stage 2 Mesothelioma Curable?

Unfortunately, no stage of mesothelioma is curable. However, therapies can control it to help people live longer. In our 2025 survey, 8% of pleural patients and 16% of peritoneal patients had experienced remission.

Pleural mesothelioma is an aggressive disease. Stage 2 mesothelioma has a better prognosis than more advanced stages of the cancer. New drugs and treatment approaches are helping patients manage this cancer as a chronic disease rather than a terminal illness.

Patients with stage 2 peritoneal mesothelioma may be eligible for surgery. They may also qualify for hyperthermic intraperitoneal chemotherapy. This treatment is also known as HIPEC. About 50% of peritoneal patients who receive HIPEC survive 5 years after diagnosis.

Cheryl Pilkington

Verified Asbestos.com Survivor

Pleural Mesothelioma Survivor Diagnosed in Stage 2

As a child, Cheryl Pilkington played in plaster dust at her father’s foundry, unaware it contained asbestos. She was diagnosed with stage 2 pleural mesothelioma 60 years later. Under the care of Dr. Matthew Steliga at the Winthrop P. Rockefeller Cancer Institute, she underwent aggressive pleurectomy and decortication surgery that helped stop her tumor growth.

Cheryl Pilkington

Verified Asbestos.com Survivor

Read Cheryl’s Story

Common Questions About Stage 2 Mesothelioma

What is the prognosis for stage 2 mesothelioma?

The prognosis for stage 2 mesothelioma is more favorable than for those diagnosed at later stages. However, because this is an aggressive cancer, most patients live for 1 to 2 years after diagnosis.

Are stage 2 mesothelioma patients more likely to be eligible for curative treatment?

Doctors consider stage 2 mesothelioma as an early-stage disease and more eligible for curative treatments such as surgery, immunotherapy and chemo. Curative treatments are therapeutic options that can extend survival.

Is multimodal treatment the most common approach for stage 2 mesothelioma?

A multimodal treatment approach is the most common and effective therapeutic option for most stage 2 mesothelioma patients. Physicians often take a multimodal approach and use multiple therapies, such as surgery and chemo, to decrease the chance of cancer recurrence.

Can cancer screenings detect mesothelioma?

Some screening tests, such as chest X-rays, CT scans and PET scans, can detect early-stage mesothelioma before symptoms develop. If you have a known history of asbestos exposure, telling your doctor can ensure you receive screenings for mesothelioma and other asbestos-related diseases.

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