Stage 2 Pleural Mesothelioma

Quick Summary

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

What is Stage 2 Pleural Mesothelioma?

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

In stage 2, the cancer is still located on one side of the body and the patient often has few symptoms. If the patient has symptoms, they are usually vague symptoms like cough, chest pain or weight loss. The doctor may not even suspect that there is cancer in the chest unless symptoms persist.

Stage 2 Symptoms

In stage 1 mesothelioma, many patients hardly notice their symptoms. This can also be true of stage 2 patients. This accounts for why some people go undiagnosed for so long.

Symptoms you may notice in stage 2 mesothelioma include:

  • Lumps in chest
  • Pain when 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 treatment. Palliative treatment helps conquer symptoms and ease pain. It makes patients more comfortable. Doctors often prescribe palliative treatment alongside curative treatment. Getting palliative care can even make it easier to cope with side effects treatment.


Symptoms lead doctors to make a diagnosis. Imaging scans of the patient’s chest can reveal tumors.

After finding a tumor, the doctors must identify it as being mesothelioma. This requires various biopsy and pathology tests. Then the doctor can confirm the diagnosis. To create a full, accurate diagnosis, doctors must 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.” Each group gets a different rating based on how far and where the tumor has spread. The TNM system not only helps doctors determine your stage, it helps determine your treatment.

Here is a quick breakdown of the TNM system:

  • (T) Tumor. Your doctor looks at the size of your tumors. They also examine the nearby tissues the tumors have spread to.
  • (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 also 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 hasn’t yet begun to 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). Stage 2 patients receive a rating of T2. This means the tumor is in on the lining of the chest wall, diaphragm and lung. It has also grown into either the lung or diaphragm. Both EPP and lung-sparing surgery can remove these tumors.

Did you know?

Patients who are properly staged get more benefits from surgery. Studies have shown that mesothelioma surgery is more effective when your doctor knows your full background. Your doctor should be aware of any cancer in lymph nodes and the pathological makeup of your tumors. This highlights the importance of seeing a specialist.


Treatment for stage 2 pleural mesothelioma is aggressive. Surgery is the best way to improve your survival time.

Many people have an EPP or a P/D to get rid of 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. These treatments will hopefully kill off any leftover mesothelioma cells in the body.


The chances of survival for those people with stage 2 mesothelioma are better than most patients.

The median life expectancy for those with stage 2 disease is 19 months. This means that half of all people will live shorter than 19 months and half of all patients will live longer than 19 months.

Stage 2 mesothelioma patients also need to consider their cell type in prognosis. Cell type can be more important in your prognosis than your stage. Most stage 2 patients have an epithelioid cell type. 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 led a large study of 636 mesothelioma patients published online in 2011. The study analyzed patients who had EPP. The goal of the study was to find factors that led to long-term survival in mesothelioma patients. One factor was epithelioid cell type. In the study, more than 100 stage 2 patients survived between 36.4 and 169.8 months. That’s 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 says, ‘no’ to surgery, consider getting a second opinion.

The patients in the study mentioned above each had an amazing initial prognosis. Still the results show that it’s possible to outlive your prognosis.

“The treatment of [pleural mesothelioma] is positioned for a major advance,” said the authors of the 2011 study.

Finding Treatment for a Longer Life

Some consider stage 2 mesothelioma as the first advanced stage. This is because tumors have started to grow past their origin. Yet, stage 2 patients still have so many treatment options. From standard chemotherapy combinations to aggressive surgeries, there is something for you.

Points to consider about stage 2 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.