Pleural Mesothelioma Stage 2

Quick Summary

Stage 2 pleural mesothelioma is still an early disease stage, but there is a slight metastasis (cancer spreading) from the pleura to other tissues or organs. Patients diagnosed at stage 2 pleural mesothelioma still have lots of treatment options that can control and stop the mesothelioma from reaching distant sites.

Pleural Mesothelioma Stage 2 Overview

It’s rare for pleural mesothelioma patients to be diagnosed as early as stage 2. If you’ve been diagnosed with stage 2 pleural mesothelioma, you can rest assured there is still hope of undergoing life-extending treatments. Here is what every stage 2 pleural mesothelioma patient should know about this disease:

  • Stage 2 is not advanced but is the first stage of pleural mesothelioma with metastasis
  • Stage 2 patients still have many important treatment options
  • Standard treatment options for patients with stage 2 mesothelioma are chemotherapy, radiation therapy, and surgery, if eligible
  • The median life expectancy of stage 2 pleural mesothelioma patients is 18-19 months
  • Aggressive surgeries can give some stage 2 pleural mesothelioma patients a chance at surviving 2 years or longer

What is Stage 2 Pleural Mesothelioma?

A stage 2 pleural mesothelioma diagnosis means that tumors that formed in the primary location (spot of origin) have spread to surrounding tissues or organs. In stage 1, small tumors originate in the pleura, which is the protective lining that covers the lungs and chest wall. By stage 2, these tumors will have either grown or spread beyond the pleura to include the lung itself (beyond the pleura) or into the diaphragm.

Stage 2 is the second of four severity levels in pleural mesothelioma growth. By stage 2, the tumor has grown out of the pleura and into other places, yet still remains contained to one side of the chest.

There are three different staging systems that doctors may use to help define what stage their patient is at. While each staging system uses a different set of criteria, generally, stage 2 means that the tumor has left the pleura and moved into the pericardium (heart covering), and/or the diaphragm, and/or nearby lymph nodes, and remains resectable (able to be removed by surgery) for the right candidate.

During stage 2 pleural mesothelioma, symptoms have increased from a persistent cough and shortness of breath to more aggressive and noticeable symptoms. By stage 2, patients usually start to suspect something is wrong, but likely never consider it to be the result of an asbestos-related disease.

What are the Symptoms of Stage 2 Pleural Mesothelioma?

Pleural Mesothelioma Symptoms Update

Pleural mesothelioma is characterized by a long latency period. It can take anywhere from 10 to 50 years after initial asbestos exposure before pleural mesothelioma symptoms become apparent. Even if patients do report their symptoms early enough, it can take another extended period for the doctors to reach an accurate diagnosis.

Everyone with a history of asbestos exposure must make themselves aware of the early warning signs of pleural mesothelioma so that it can be diagnosed before it reaches advanced stages.

Here are some of stage 2 pleural mesothelioma symptoms and signs to be aware of:

  • Dry, persistent cough
  • Worsening chest pain
  • Sudden and unexplained weight loss
  • Chronic fever
  • Continued difficulty breathing

In general, stage 2 pleural mesothelioma symptoms have become more apparent. What may have started out as a cough that you attributed to sickness has not only not gone away, but has worsened in a noticeable way. Depending where the tumor has spread to, you may also notice lumps of tissue building up in your chest.

Stage 2 Pleural Mesothelioma Prognosis

While the overall prognosis for people with stage 2 pleural mesothelioma is not good, it’s still considerably better than those patients diagnosed at late stages. That’s because stage 2 pleural mesothelioma patients still have a number of treatment options available to them. They also have more time in terms of life expectancy, which gives them room to try other treatments if standard treatments fail.

The median life expectancy of stage 2 mesothelioma patients is around 18 months.

At stage 2, pleural mesothelioma patients are likely still eligible for surgery. While still being relatively localized, stage 2 pleural mesothelioma may still be respectable, which means it can be removed surgically. Many patients who undergo resectable surgery in stage 2 can increase their life expectancy to 2 years or longer.

It’s important for all patients diagnosed with stage 2 pleural mesothelioma to still maintain hope. Catching it this early is a very positive thing, as most people aren’t diagnosed until stage 3. Additionally, a prognosis is not a fact and is usually a conservative estimate of how the disease will progress. Be sure to ask your healthcare team about specific things you can do to improve your prognosis.

Stage 2 Pleural Mesothelioma Treatment Options

In stage 2 pleural mesothelioma, doctors are concerned with controlling the mesothelioma and prevent further metastasis. The treatment goals of stage 2 pleural mesothelioma are to remove as much of the tumors as possible and to prevent mesothelioma cells from spreading to distant sites such as to the lymph nodes or other side of the body.

In the best case scenario, the patient will be a good candidate for surgery to remove tumors. A good surgical candidate is one who is healthy enough to withstand potential surgical complications and who can successfully recover from surgery. Prior to surgery, doctors may administer chemotherapy and/or radiation therapy to shrink the tumors to make them easier to remove.

Depending on your case, doctors may recommend one of two standard pleural mesothelioma surgeries:

  • Extrapleural Pneumonectomy: The EPP is an aggressive surgical procedure for stage 1 or 2 patients. During EPP, doctors remove the affected lung, the pleura, part of the diaphragm, and possibly the pericardium (heart covering) and nearby lymph nodes.
  • Pleurectomy With Decortication: The P/D procedure is a less radical alternative to the EPP that doesn’t involve removing the lung. During P/D, the surgeon removes the entire diseased pleura on the affected side.

There is a debate in the medical community over which of these surgeries is better for the patient. Overall, both surgeries produce similar survival rates when performed in comparable cases. It is ultimately up to you and your healthcare team to determine which of these two surgeries you’re a better candidate for.

Regardless of which surgery you undergo, it will be followed by several weeks of chemotherapy. As an anticancer drug, chemotherapy circulates throughout the body and kills off remaining mesothelioma cells that were left behind after surgery, Doctors may also recommend postoperative radiation to destroy any remaining mesothelioma cells left at the tumor sites.

Compensation for Stage 2 Pleural Mesothelioma Treatments

Stage 2 pleural mesothelioma requires aggressive treatments performed quickly to prevent the mesothelioma from progressing to stage 3. By stage 3, a pleural mesothelioma patient’s treatment options are much more limited. Getting the best possible treatment can mean the difference between a few months and a few years to live with your diagnosis.

Pleural mesothelioma patients are victims of asbestos exposure on the part of negligent companies. Because of this, patients are typically eligible for legal compensation through asbestos bankruptcy trusts, lawsuits or VA benefits for veterans. If you’ve been diagnosed with pleural mesothelioma, contact one of our Patient Advocates today. Call us at (800) 584-4151 or receive a FREE Mesothelioma Help Guide to better understand your stage 2 pleural mesothelioma treatment options.

View Author and Sources

  1. Winston W Tan, MD, FACP, “Malignant Pleural Mesothelioma Treatment Protocols.” Medscape. Accessed on December 16, 2017.
  2. Journal of Thoracic Disease, “Management of malignant pleural mesothelioma—The European experience” Retrieved from: Accessed on December 16, 2017.

Last modified: October 15, 2018