Pleural Mesothelioma Stage 1

Quick Summary

Stage 1 pleural mesothelioma is the earliest stage of this rare, asbestos-caused cancer. In stage 1, mesothelioma remains localized within the lung lining (pleura). Stage 1 pleural mesothelioma patients have the best prognosis due to the many treatment options available to them, which includes surgery, chemotherapy and radiation therapy.

Pleural Mesothelioma Stage 1 Overview

Patients diagnosed with stage 1 pleural mesothelioma have the greatest chance at long-term survival.

If you’ve been diagnosed with stage 1 pleural mesothelioma, here is what you need to know about this disease:

  • Stage 1 is the least advanced stage of mesothelioma (non-metastatic)
  • Stage1 pleural mesothelioma has the most treatment options available
  • Primary treatment options for stage 1 mesothelioma are surgery, chemotherapy and radiation therapy
  • Life expectancy of stage 1 pleural mesothelioma patients is 21 months
  • Aggressive surgeries and multimodal therapies can give some patients a chance at increasing their life expectancy by several years

What Is Stage 1 Pleural Mesothelioma?

If you’ve been diagnosed with stage 1 pleural mesothelioma, it means that a small tumor has started to develop within the pleura of one of your lungs or your chest wall.

The pleura is the protective tissue that covers the lungs and the chest wall. Its purpose is to not only contain and protect these organs, but to allow flexibility so the lungs can comfortably expand when breathing. When the pleura becomes compromised by early-growth tumors, it may create subtle symptoms that are often difficult to detect at first.

Stage 1 pleural mesothelioma is the earliest stage of this cancer. In stage 1 patients, the mesothelioma remains localized at the site of the primary tumor—the spot where the mesothelioma originated.

What Does Stage 1 Mean?

Different staging systems define stage 1 pleural mesothelioma in different ways. In general, stage 1 refers to the tumor not having metastasized (spread), remains contained to one side of the chest, and is still resectable—a term meaning the cancer is removable by surgery.

Stage 1 pleural mesothelioma has two substages—stage 1A and stage 1B:

  • Stage 1A Pleural Mesothelioma: The tumor has developed within the parietal layer of the pleura, which is the layer of the pleura closest to the chest wall.
  • Stage 1B Pleural Mesothelioma: The tumor has developed within the visceral layer of the pleura, which is the layer of the pleura that lines the lungs.

Stage 1 is the only stage of pleural mesothelioma that is divided into substages.

What Are the Symptoms of Stage 1 Pleural Mesothelioma?

Stage 1 pleural mesothelioma symptoms are often overlooked or mistaken for other respiratory conditions, such as bronchitis or pneumonia.

Pleural Mesothelioma Symptoms Update

Pleural mesothelioma has a long latency period. Symptoms don’t develop until 10-50 years after asbestos exposure, which is the only known cause of mesothelioma. This delay in symptoms combined with the fact that mesothelioma is so rare, making it a difficult condition to diagnose in stage 1.

Stage 1 pleural mesothelioma symptoms may include:

  • Dry, persistent cough
  • Shortness of breath
  • Body aches
  • Possible fever

Vague symptoms such as these experienced in stage 1 can also be easily attributed to cold and flu. In smokers, these symptoms may be so familiar that patients may not think twice about a persistent cough being the result of anything more serious. As a result of these factors, it is extremely rare for doctors to diagnose mesothelioma at stage 1.

Stage 1 Pleural Mesothelioma Prognosis

The general prognosis for stage 1 pleural mesothelioma is considered good compared to later stages. However, it’s still a condition for which there is no cure. Catching it early gives patients the ability to undergo potentially life-extending treatments.

The median life expectancy of stage 1 pleural mesothelioma patients is 21 months.

For patients who are healthy enough to undergo surgery, it can increase life expectancy. One study showed that stage 1 patients have a 60% increased chance of surviving 30 months or longer with resectable surgery.

Factors Affecting Stage 1 Prognosis

As with all forms of cancer, a prognosis is given on an individual basis. Your mesothelioma specialist will look at factors like your age, health and lifestyle, which all play a significant role in how you respond to treatments.

Mesothelioma cell type is another factor that determines prognosis. Sarcomatoid, though rare, is a difficult cell type to treat because it spreads so quickly and irregularly. Epithelioid has the best prognosis, and biphasic—or mixed cell type—falls in between.

Stage 1 Pleural Mesothelioma Treatment Options

Stage 1 pleural mesothelioma patients have the most life-extending treatment options available to them.

Because the tumor remains localized, it’s much easier for surgeons to remove cancer before it spreads to distant sites. For stage 1 pleural mesothelioma patients, time is of the essence. By nature, cancer cells spread at abnormally fast rates, so getting the mesothelioma removed right away is essential to survival.

Doctors remove and stop stage 1 pleural mesothelioma from spreading with one of the following two standard surgical procedures:

  • Extrapleural Pneumonectomy: EPP is an aggressive surgery available to pleural mesothelioma patients at stages 1 or 2. It involves removing the affected lung, the pericardium (heart covering), as well as the pleura of the chest wall and the diaphragm on that same side. Only highly skilled and experienced mesothelioma surgeons can perform this surgery.
  • Pleurectomy With Decortication: P/D was developed as an alternative surgery to the EPP. During P/D, the surgeon removes only the diseased pleura as opposed to the entire lung. For some patients, this may be a better option so that they can maintain the function of both lungs.

Which procedure is better for patients is a fairly contentious issue in the mesothelioma medical community. Some specialists feel that the EPP puts patients at unnecessary risk of surgical complications, while others feel that it’s the best option for minimizing the risk of recurrence—when the mesothelioma comes back.

Studies have shown that both procedures produce similar survival rates when performed in comparable cases. The decision between these two procedures is ultimately up to the patient and their medical team.

Chemotherapy and Radiation for Stage 1

Regardless of which procedure you undergo, all stage 1 mesothelioma patients also receive chemotherapy and/or radiation therapy after their surgery. Chemotherapy is an anticancer drug that circulates through the patient’s body, killing off all mesothelioma cells in its path that may have been left behind after surgery.

Pleural mesothelioma patients often undergo multiple weeks of postoperative chemotherapy as an added precaution to prevent recurrence.

Radiation therapy involves high-energy beams aimed directly at the mesothelioma site. These beams interfere with the cancer cells’ DNA, which prevents them from receiving instructions to divide. When mesothelioma cells cannot divide, they die off, which effectively stops mesothelioma from continuing to spread.

Compensation for Stage 1 Pleural Mesothelioma Treatments

Pleural mesothelioma patients are victims of asbestos exposure caused by negligent manufacturers. As a result, legal recourse is available to most mesothelioma patients regardless of how they were exposed to asbestos. Successful claims against asbestos companies can result in compensation that covers treatment costs as well as other expenses and damages that patients incur.

To learn more about to obtain the best stage 1 pleural mesothelioma treatments possible, contact one of our Patient Advocates today. We work with mesothelioma patients daily to support you through your diagnosis and advocate to help get you access to life-extending treatments. Call us today at (800) 584-4151.

View Author and Sources

  1. American Cancer Society, “How is Malignant Mesothelioma Staged?” Retrieved from: Accessed on December 15, 2017.
  2. American Cancer Society, “Surgery for Malignant Mesothelioma” Retrieved from: Accessed on December 15, 2017.

Last modified: October 24, 2018