7 Min Read
Last Updated: 05/29/2024
Fact Checked

Written by Karen Selby, RN | Medically Reviewed By Dr. Jacques Fontaine | Edited By Walter Pacheco

What Is Stage 2 Mesothelioma?

Stage 2 mesothelioma is a diagnosis that means cancer has spread outside the original location. Tumors involve deep tissue near the original site and may invade nearby lymph nodes, such as hilar lymph nodes. These lymph nodes, also known as N1 lymph nodes, are located at the root of the lung.

The stages of the disease progress from stage 1 to stage 4. Stages 1 and 2 are considered early-stage mesothelioma.

Peritoneal mesothelioma has no formal staging system. Doctors often define peritoneal mesothelioma as stage 2 if there is local tumor growth that involves the lymph nodes. The main difference between stage 2 and stage 1 disease is tumor cells in the hilar lymph nodes.

Stage 2 Mesothelioma
Stage 2 Mesothelioma

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.

Key Facts About Stage 2 Mesothelioma
  • Stage 2 is an early-stage diagnosis without significant symptoms.
  • Tumors are in the membrane lining the chest cavity and surrounding the lungs.
  • Cancer cells may have spread into nearby lymph nodes.
  • Surgery, chemotherapy, radiation and immunotherapy are available in stage 2.
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Stage 2 Mesothelioma Symptoms

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

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

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.

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.

5%

Percentage of respondents to The Mesothelioma Center’s 2023 patient survey who were diagnosed with stage 2 mesothelioma.

While only 11% of respondents in our survey were diagnosed with stage 1 or 2 mesothelioma (early stage), 40% were diagnosed with stage 3 or 4 (late stage). Doctors most often diagnose mesothelioma cases after the cancer has already spread beyond stage 2. Sometimes, they may recognize it sooner.

Cancer screenings identify some stage 2 cases. Doctors often find mesothelioma when checking a patient’s chest for an unrelated reason such as chest pains, chronic cough or other chest conditions.

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 reveal the seriousness of this diagnosis, but they cannot predict the outcome for an individual patient.

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

The American Cancer Society explains, “People now diagnosed with mesothelioma may have a better outlook than these numbers show. Treatments improve over time, and these numbers are based on people diagnosed and treated at least five years earlier.”

Survivor Story
Cheryl Pilkington Pleural mesothelioma

Pleural Mesothelioma Survivor Diagnosed in Stage 2

Survivor Story

Cheryl Pilkington was fortunate to be diagnosed with mesothelioma in stage 2, which is earlier and more treatable than when most patients are diagnosed. Pilkington underwent aggressive pleurectomy and decortication surgery at Winthrop P. Rockefeller Cancer Institute in Little Rock, Arkansas, under the care of thoracic surgeon Dr. Matthew Steliga.

Read Cheryl’s Story

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. Many physicians recommend an approach that includes surgery, chemotherapy and radiation for pleural and peritoneal mesothelioma patients.

Treating Stage 2 Mesothelioma
  • Chemotherapy: The chemotherapy combination of pemetrexed (Alimta) and cisplatin or carboplatin is the most common treatment for pleural mesothelioma. For patients with stage 2 peritoneal mesothelioma, chemotherapy can be circulated throughout the abdominal cavity during surgery to remove visible tumors.
  • Immunotherapy: Many people diagnosed with stage 2 mesothelioma qualify for checkpoint inhibitors and other immunotherapies. Drugs such as pembrolizumab (Keytruda), nivolumab (Opvido) and ipilimumab (Yervoy) use the body’s immune system to target and fight cancer cells.
  • Radiation: Doctors may use radiation to shrink tumors before surgery or prevent local recurrence after surgery. Palliative radiation therapy can ease symptoms and improve quality of life.
  • Surgery: Extrapleural pneumonectomy and pleurectomy with decortication are the two main surgical options for mesothelioma patients. A patient’s overall health and tumor locations determine which option doctors choose.

2022 study on pleural mesothelioma patients at stages 1 and 2 found multimodal therapy safe and effective at improving survival. Participants underwent induction chemotherapy, surgery, postoperative radiation therapy and chemotherapy.

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 the cancer to help people live longer with mesothelioma. In our 2023 survey, 10% of pleural patients and 21% of peritoneal patients said they had experienced remission.

Pleural mesothelioma is an aggressive disease. Most patients do not survive longer than 2 years after diagnosis. 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 will be alive five years after diagnosis.

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Common Questions About Stage 2 Mesothelioma

What is the prognosis for stage 2 mesothelioma?

The prognosis for stage 2 mesothelioma maybe favorable. 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 chemotherapy. 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 chemotherapy, 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 the presence of early-stage mesothelioma before symptoms develop. If you have a known history of asbestos exposure, informing your health care team will ensure you receive screening for mesothelioma and other asbestos-related diseases.

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