7 Min Read
Last Updated: 06/05/2024
Fact Checked

Written by Dr. Daniel Landau | Medically Reviewed By Dr. Jacques Fontaine | Edited By Walter Pacheco

Fact Checked

Development of Stage 1 Mesothelioma

In stage 1 mesothelioma, cancer cells have not yet spread through the lymph nodes or far beyond the pleural lining.

Early-stage mesothelioma cancer has a better prognosis than cancer diagnosed in later stages. Surgery, radiation and chemotherapy are more effective at controlling stage 1 disease.

Stage 1 mesothelioma tumor progression
Asbestos fibers lead to tumor development on the pleural lining.

Mesothelioma symptoms do not develop until later stages of disease progression. When stage 1 cases are discovered, it is often 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.

Defining Stage 1 Mesothelioma

There are three staging systems for evaluating how far pleural mesothelioma has spread. They use somewhat different definitions for stage 1. The TNM staging system is the most commonly used. The first stage of pleural mesothelioma is divided into two parts: 1A and 1B.

Stage 1 Mesothelioma
  • Stage 1A: In stage 1A, tiny tumors develop in one or both layers of the pleural lining on one side of the chest.
  • Stage 1B: 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 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 cancer has not spread to any lymph nodes or metastasized to 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.

Key Facts About Stage 1 Mesothelioma
  • Two-year survival rate is between 41% and 46%.
  • Often causes no major symptoms.
  • Cancer can be removed if the patient is eligible for surgery.
  • Combination of surgery, chemotherapy and radiation recommended.

What Are the First Signs of Mesothelioma?

The first signs of mesothelioma include pain, difficulty breathing or a chronic cough. These symptoms typically begin to appear in stage 3 of mesothelioma but may appear as early as stage 2 for some patients.

At stage 1, most patients do not have symptoms. Some are so mild that patients do not feel they need medical attention. Mesothelioma is rarely diagnosed at stage 1 for this reason. Fluid buildup may cause these symptoms because of pressure on the lung. This is a condition called pleural effusion, and it is a common sign of cancer forming in the lining of the lungs.

My story begins at the end of April 2015, when I went to my general practitioner’s office because of a cough and an unusual lack of energy. I thought maybe I was coming down with a case of pneumonia.

In 2020, the Journal of Surgical Case Reports described a pleural mesothelioma patient whose first and only sign of the disease was gastric and colonic polyps discovered on an imaging scan. Testing of the polyps revealed they were metastases of pleural mesothelioma.

Is There a Cure for Stage 1 Mesothelioma?

There is no cure for mesothelioma yet even if the cancer is detected at an early stage, but stage 1 patients have more treatment options. The prognosis for stage 1 mesothelioma is favorable.

Patients eligible for surgery may be able to have mesothelioma completely removed. Those diagnosed with mesothelioma early enough to qualify for surgery have the best chance of achieving remission.

Life is good today. I feel great, and I’m living the way I want to live. Doctors keep saying, ‘There is no cure for mesothelioma,’ but here I am today.

Some early-stage patients have gone into remission for years after treatment. Remission means the cancer has stopped growing and spreading.

Mesothelioma specialists are optimistic emerging treatments may soon enable them to manage this cancer as a chronic disease vs. a terminal illness. A significant number of mesothelioma survivors have lived for years beyond their original prognosis thanks to new treatment strategies.

Survival Rate for Stage 1 Mesothelioma

Stage 1 patients have a better prognosis compared to patients diagnosed at other stages of mesothelioma. Approximately 41% to 46% of stage 1 mesothelioma patients survive two years. About 24% survive five years. For comparison, stage 4 patients usually live around one year, and 7% survive five years.


Percentage of stage 1 pleural mesothelioma patients who live at least five years.

Survival rates are calculated from the statistics for thousands of patients. The rate shows the percentage of patients still alive a certain amount of time after diagnosis. This rate explains what happened to a large group of patients in the past. It can only give you a general idea about what to expect from an individual diagnosis in the present.

Stage 1 malignant mesothelioma life expectancy depends on many factors. These include cancer cell type and the patient’s age and physical fitness level. Mesothelioma is a rare, complex disease, and every case is different.

How Age Impacts Prognosis for Stage 1 Mesothelioma

Younger patients diagnosed with early-stage mesothelioma often have a better prognosis. They also have more treatment options than patients over 55 years of age.

Younger patients have a higher five-year survival rate due to their health and surgical eligibility. Research shows patients over 70 also benefit if they are candidates for pleurectomy with decortication.

The average age of a mesothelioma patient is 69, and about 8% of male patients ages 65 to 74 live for five years or more. Meanwhile, women in the same age group have a 14.1% five-year survival rate.

Stage 1 Mesothelioma Treatment

Surgery is the primary treatment for stage 1 patients. Radiation, chemotherapy or both will occur around the time of surgery. These will help improve long-term remission rates. Talk to your doctor to learn how they prefer to sequence therapy because it can vary from center to center.

A 2022 study published by Multidisciplinary Digital Publishing Institute that included stage 1 and 2 pleural mesothelioma patients found multimodal therapy safe and effective at improving survival.

Patients underwent induction chemotherapy, surgery, and postoperative radiation therapy and chemotherapy. The median overall survival was 32.1 months, which is a significant improvement from the average 12-month survival.

Dr. Jacques Fontaine and Dr. Virginia Wolf
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Treatment Options for Stage 1 Mesothelioma

Patients with localized cancer have the most treatment options available to them. But it also depends on the patient’s overall health. Patients must be in strong health to handle an aggressive treatment plan. Patients who undergo multimodal therapy may live years beyond the average mesothelioma prognosis.

Stage 1 Treatment
  • Chemotherapy: Doctors may use chemotherapy on its own or in combination with surgery for stage 1 patients. After a patient recovers from surgery, they usually receive chemotherapy. The goal is to kill any remaining cancer cells in their body.
  • Immunotherapy: The U.S. Food and Drug Administration approved two immunotherapy drugs, Opdivo and Yervoy, for pleural mesothelioma in 2020.
  • Radiation Therapy: Doctors traditionally use radiation therapy after surgery to prevent local recurrence. Radiation therapy after surgery might improve survival rates for certain stage 1 patients.
  • Surgery: Surgery removes the diseased tissue around the lung and may involve the removal of the lung. Which option is best depends on how far the cancer has spread and how much surgery the patient’s body can handle.

Many early-stage patients in otherwise good health qualify for mesothelioma clinical trials. These voluntary research studies test experimental drugs and therapies not yet approved by the U.S. Food and Drug Administration for mainstream use. Emerging therapies for mesothelioma include new immunotherapies, gene therapy and photodynamic therapy.

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