Stage 1 mesothelioma is the earliest diagnosis of the disease. Because tumors remain localized in and around the tissue lining of one lung, it offers more treatment options for a longer life expectancy. Prognosis is better at this stage, and the 2-year survival rate for some patients is 41-46 percent.
At stage 1 pleural mesothelioma, tumors have developed on the pleura, which is the thin protective tissue surrounding the lungs.
Cancer cells have not yet spread through the lymph nodes or bloodstream.
Early-stage mesothelioma typically has a better prognosis than cancer diagnosed in later stages. Surgery, radiation and chemotherapy are more effective at controlling stage 1 disease and prolonging life.
The first stage of pleural mesothelioma is commonly divided into two parts: 1A and 1B. In stage 1A, tiny tumors develop in one or both layers of the pleural lining on one side of the chest.
In stage 1B, the tumors start spreading into other tissues next to the pleural lining. This may include the lung tissue under the lining or the chest wall outside of it. Cancer could also spread into the muscle under the lungs (the diaphragm) or the area between the lungs (the mediastinum).
Even if mesothelioma has spread to nearby tissues, a stage 1 diagnosis means the cancer has not spread to any lymph nodes or distant sites throughout the body.
Peritoneal mesothelioma does not have an official staging system. However, doctors typically think of it as early-stage cancer if it has not spread beyond the lining of the abdomen.
Mesothelioma cancer is rarely diagnosed at stage 1.
At this stage, most patients do not have symptoms, or symptoms are so mild patients do not feel they need medical attention.
Mesothelioma has an unusually long latency period, meaning it can take decades after the initial asbestos exposure before cancer develops.
Stage 1 cases are often discovered by accident when a doctor performs an X-ray or CT scan while looking for something else. Other stage 1 cases are caught because a patient with a known history of asbestos exposure received cancer screening.
Patients and doctors often mistake mesothelioma symptoms for more common illnesses such as the flu or pneumonia. As the tumors wrap around the affected lung, constricting it, the patient may experience pain, difficulty breathing or a chronic cough.
These symptoms can also be caused by fluid building between the two layers of the pleural lining, which puts pressure on the lung. This condition is called pleural effusion, and it is a common sign of cancer forming in the lining of the lungs.
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There are three staging systems for evaluating how far pleural mesothelioma has spread, and they use somewhat different definitions for stage 1. The TNM system is the most commonly used.
Patients with localized cancer have the most treatment options available to them, though it also depends on the patient’s overall health.
Doctors recommend a multimodal approach combining surgery, chemotherapy and radiation therapy for stage 1 patients in good enough health to handle an aggressive treatment plan.
Patients who undergo multimodal therapy may live years beyond the average mesothelioma prognosis.
There are two major surgery options for pleural mesothelioma. One removes the diseased tissue around the lung, while the other also removes the lung.
Which option is best depends on how far the cancer has spread and how much surgery the patient’s body can handle.
Doctors may use chemotherapy on its own or in combination with surgery. After a patient recovers from surgery, they usually receive chemotherapy drugs to kill any remaining cancer cells in their body.
Some treatment plans use chemotherapy to shrink tumors before surgery.
Many early-stage patients in otherwise good health qualify for mesothelioma clinical trials.
These voluntary research studies test experimental immunotherapy drugs, genetic therapies and treatment combinations not yet approved by the U.S. Food and Drug Administration for mainstream use.
The prognosis for stage 1 mesothelioma is favorable compared to later stages, but the fact remains that pleural mesothelioma is an aggressive cancer with no cure.
In the past, most patients have not survived longer than two years after diagnosis.
Every day, doctors and researchers work to develop treatment strategies in hope of finding a cure. At the same time, many mesothelioma specialists are optimistic they may soon be able to manage this form of cancer as a chronic disease, rather than a terminal illness.
A number of notable mesothelioma survivors — particularly among those with peritoneal mesothelioma — have outlived their prognosis by years thanks to new treatment techniques.
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Life expectancy with stage 1 mesothelioma depends on a number of factors, especially the cancer cell type and the patient’s age and physical fitness level.
Mesothelioma is a rare, complex disease, and every case is different.
Survival rates are calculated from the statistics for thousands of patients. The rate shows the percentage of patients who were still alive a certain amount of time after they were diagnosed.
This rate explains what happened to a large group of patients in the past, so it can only give you a general idea about what to expect from an individual diagnosis in the present.
Karen Selby joined Asbestos.com in 2009. She is a registered nurse with a background in oncology and thoracic surgery and was the director of a tissue bank before becoming a Patient Advocate at The Mesothelioma Center. Karen has assisted surgeons with thoracic surgeries such as lung resections, lung transplants, pneumonectomies, pleurectomies and wedge resections. She is also a member of the Academy of Oncology Nurse & Patient Navigators.