Stage 2 mesothelioma is an early cancer stage when cancer cells may not have spread far but are entering nearby lymph nodes. Stage 2 prognosis may still be favorable, and many treatment options are available to extend life expectancy. The 2-year survival rate at this stage is around 38%.
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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.
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Get Your GuidePeritoneal 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 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
“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.”
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).
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Find Your DoctorMedian 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.
What are the differences between early-stage and late-stage cancer?
[MUSIC PLAYING] Early stage cancer diagnosis will provide a lot of options for the patient. An early stage patient might be eligible for surgery, such as having that pleura removed, or extrapleural pneumonectomy, which means having the entire lung removed. Early stage means that the cancer is contained within the primary location of the diagnosis, hasn’t gone beyond that primary location. So that means lymph nodes aren’t involved, the chest wall is not involved. Late stage means that there’s a lot more things involved in the cancer. It’s gone beyond that primary location. It doesn’t mean that there’s not treatment options, it just means it’ll be a different course, perhaps surgery won’t be the first thing that is offered to the patient. [MUSIC PLAYING]
Stage 2 mesothelioma treatment options include chemotherapy, immunotherapy, surgery, and radiation. Doctors also use multimodal therapy, which combines 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
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.
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
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
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.
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.
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.
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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Selby, K. (2026, February 10). Stage 2 Mesothelioma. Asbestos.com. Retrieved February 10, 2026, from https://www.asbestos.com/mesothelioma/stage-2/
Selby, Karen. "Stage 2 Mesothelioma." Asbestos.com, 10 Feb 2026, https://www.asbestos.com/mesothelioma/stage-2/.
Selby, Karen. "Stage 2 Mesothelioma." Asbestos.com. Last modified February 10, 2026. https://www.asbestos.com/mesothelioma/stage-2/.
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Dr. Jacques Fontaine is a thoracic surgeon at Moffitt Cancer Center in Tampa, Florida, where he heads up the Mesothelioma Research and Treatment Center. He specializes in minimally invasive robotic surgery and aggressive surgeries for mesothelioma.
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