Stage 2 Pleural Mesothelioma

Stage 2 pleural mesothelioma is when the cancer has spread locally and symptoms are more obvious. Patients with stage 2 pleural mesothelioma still have a prognosis similar to patients with stage 1. Treatments include chemotherapy, radiation therapy, and surgery.

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What Is Stage 2 Pleural Mesothelioma?

Lungs with Pleural Mesothelioma Stage 2

Stage 2 malignant pleural mesothelioma means that the cancer has spread from its origin point. Tumors have grown to other areas of the lung tissue, lining of the lung, diaphragm, or pericardium.

In stage 2, the cancer is still on one side of the chest, and the patient often presents a few vague symptoms such as chest pain, coughing, or weight loss. Doctors may not even suspect that there is cancer in the chest unless symptoms persist.

Without treatment, the cancer can progress into more advanced mesothelioma stages. These later stages limit treatment options and overall survival.

Stage 2 Mesothelioma Symptoms

In stage 1 of pleural mesothelioma, many patients hardly notice their symptoms since the cancer is in such an early stage. This can also be true of stage 2 mesothelioma patients, which is why some patients remain undiagnosed for so long.

Symptoms patients may notice in stage 2 pleural mesothelioma include:

  • Lumps in the chest
  • Painful breathing
  • Shortness of breath
  • Unexplained weight loss

During stage 2 mesothelioma, symptoms are still relatively manageable without treatment. But even at this stage, doctors recommend palliative treatments to diminish the severity of symptoms, ease pain, and make patients more comfortable.

Doctors often prescribe palliative treatment alongside curative treatment. Palliative care can also make it easier to cope with the side effects of treatment.

If you have an upcoming appointment with an oncologist or surgeon, you may feel overwhelmed about what to discuss. Request our free guide of 14 Questions to Ask Your Doctor, which is designed to help you will feel more prepared for this life-changing conversation.

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Stage 2 Pleural Mesothelioma Diagnosis

Doctors use symptoms to make early judgments, but only imaging scans can reveal tumors. Those tumors must be further tested through biopsies and pathology tests in order to accurately be identified as mesothelioma.

Once all these steps are completed, doctors can confirm a mesothelioma diagnosis and properly stage your disease.

The TNM Staging System

There are several systems for staging mesothelioma. One of the most agreed upon is the TNM system. This acronym stands for “tumor, node, and metastasis.” This system is used by the American Cancer Society (ACS).

Each facet of this ranking system gets a different rating based on the tumor’s location and the degree to which it has spread. This helps doctors determine your stage and treatment plan.

Here is a quick breakdown of the TNM system:

  • (T) Tumor: Doctors examine the size of your tumors and the nearby tissues the tumors have spread to thus far.
  • (N) Node: Mesothelioma spreads through the lymph system. When it reaches the lymph nodes, the cancer gets trapped. Doctors use this to measure how far your disease has traveled. Stage 2 patients have no lymph node involvement.
  • (M) Metastasis: Doctors look for mesothelioma in distant organs. Stage 2 patients have no signs of metastasis.

The node and metastasis groups are rated as N0 and M0 in stage 1 and 2 mesothelioma. This means your cancer has not spread beyond its origin.

The tumor group in the TNM system has ratings from T0 (no sign of tumor at the origin) to T4 (the tumor is inoperable). Pleural mesothelioma stage 2 patients receive a rating of T2. This means the tumor is in the lining of the chest wall, diaphragm, and lung. It has also grown into either the lung or diaphragm.

A lung removal surgery called extrapleural pneumonectomy (EPP) or a lung-sparing surgery called pleurectomy with decortication (P/D) can be performed to remove these tumors from the chest cavity.

Stage 2 Pleural Mesothelioma Treatment

a group of doctors gather around a table to conduct a surgery

Surgery is the best aggressive treatment for stage 2 pleural mesothelioma.

Many people undergo an EPP or a P/D to remove as many tumors as possible. The type of surgery may depend on your doctor's opinion or your specific condition.

Surgery is often followed by chemotherapy and radiation therapy. These mesothelioma treatments will hopefully kill off any leftover mesothelioma cells in the body.

Newer treatments are becoming available through clinical trials. Immunotherapy for pleural mesothelioma was approved after being studied in these trials for years.

Immunotherapy trains the body to destroy cancer cells within the pleura (lung lining), abdominal cavity, and beyond.

Consult a doctor who can help develop the right treatment plan to improve your survival time.

Stage 2 Pleural Mesothelioma Prognosis

The median life expectancy for patients with stage 2 pleural mesothelioma disease is 19 months. This means that 50% of all patients will live less than 19 months and 50% will live longer than 19 months.

Mesothelioma stage 2 patients also need to consider their cell type in mesothelioma prognosis. Cell type can be more important in your prognosis than your stage.

Most mesothelioma stage 2 patients have epithelioid cancer cells. This cell type has the best prognosis. Biphasic and sarcomatoid cell types spread faster. Patients with non-epithelioid cell types may advance in stage faster than other stage 2 patients.

Did you know?

The late Dr. David Sugarbaker spearheaded a study of 636 mesothelioma patients to explore factors that led to long-term survival in mesothelioma patients. The 2011 study analyzed patients who underwent an EPP. Results indicated that more than 100 stage 2 patients survived between 36.4 and 169.8 months, or between 3 and 14 years.

Some doctors hesitate to operate on patients with biphasic or sarcomatoid cell types. But stage 2 patients may still be good candidates for surgery. If your doctor declines to perform this surgery, consider getting a second opinion.

If you are a veteran who has been diagnosed with stage 2 pleural mesothelioma, you may be entitled to additional benefits from the U.S. Department of Veterans Affairs (VA). Request our free Veterans Packet to explore your options.

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Finding Treatments for Longevity

Some consider stage 2 pleural mesothelioma as the first advanced stage because tumors have started to grow past their origin. Yet, stage 2 patients still have so many treatment options.

Key takeaways about stage 3 pleural mesothelioma:

  • Survival rates are improving every day.
  • Surgical treatment is the best way to improve your outlook.
  • Finding a specialist is the key to a longer life.

If you have been diagnosed with stage 2 mesothelioma, the time to act is now. Many patients diagnosed at this stage have reached remission. They accomplished this with a little luck and the best mesothelioma specialists they could find. There are people who can help you find a specialist in the VA and get you financial compensation for your disease. Get help from a VA claims agent now.

Stage 2 Mesothelioma: Common Questions

What are the characteristics of stage 2 mesothelioma?

The characteristics of stage 2 mesothelioma include cancerous tumors that have spread from their origin point to nearby organs but are still on one side of the chest.

Patients often have a few vague symptoms, including chest pain, coughing, or weight loss.

How long can you live with stage 2 mesothelioma?

The median stage 2 mesothelioma life expectancy is about 19 months. Statistically, half of all patients who have been diagnosed with stage 2 mesothelioma will live for less than than 19 months while the other half will live for longer than 19 months.

What is the survival rate of stage 2 mesothelioma?

The mesothelioma stage 2 survival rate is about 70% during the first year and about 40% throughout the second year following a diagnosis.

Veterans Support Team
Todd Gersten, MD PhotoReviewed by:Todd Gersten, MD

Double Board-Certified Oncologist and Hematologist

  • Fact-Checked
  • Editor

Todd Gersten, MD, is a double board-certified medical oncologist and hematologist specializing in general adult oncology and hematologic disease. He is a physician partner with the Florida Cancer Specialists and practices in Wellington, Florida.

Dr. Todd Gersten is an independently paid medical reviewer.

Christopher Dryfoos PhotoWritten by:

Contributing Author

Christopher Dryfoos is a journalist and member of the American Medical Writers Association (AMWA). As the grandson of the U.S. Navy’s first forensic pathologist, he aims to help veterans with mesothelioma access needed care.

  1. American Cancer Society. “Malignant Mesothelioma Early Detection, Diagnosis, and Staging.” Retrieved from: Accessed on March 22, 2024.
  2. Nakas, A., Waller, D. Predictors of long-term survival following radical surgery for malignant pleural mesothelioma. European Journal of Cardio-Thoracic Surgery, 46(3), 380–385. Retrieved March 22, 2024, from
  3. Sugarbaker, D. J. , Wolf, A. S., Chirieac, L. R., et al. Clinical and pathological features of three-year survivors of malignant pleural mesothelioma following extrapleural pneumonectomy. European Journal of Cardio-Thoracic Surgery, 40(2), 298–303. Retrieved March 22, 2024, from