Medically Reviewed by: Muaiad Kittaneh, MD, FACP, MBA | May 20th, 2020
Of the four stages of pleural mesothelioma, the second stage is relatively treatable. Since the disease is still technically in the earlier stages, tumors haven’t spread too far and doctors will usually recommend curative treatments. These can include one or a combination of surgery, chemotherapy, radiation, or targeted treatments to treat the tumors. Peritoneal and pericardial generally don’t really have a ‘stage 2’ since doctors use a different staging system. Peritoneal mesothelioma is staged using the Peritoneal Cancer Index (PCI), and for pericardial mesothelioma, since it’s so aggressive, doctors or patients don’t usually realize there are tumors until they’re very advanced, or the patient has already passed away.
Most cancers are staged on a scale of 1 through 4. At stage 2, mesothelioma is still considered an early-stage diagnosis. There is limited spreading throughout the body, though tumors have likely reached the lymph system. Patients are usually eligible for treatment options that can remove or shrink the tumors, such as surgery, chemotherapy, radiation, or immunotherapy.
At stage 2, patients may begin to experience mild symptoms. However, because symptoms may mirror those of less severe conditions, the disease often goes undiagnosed until it has reached more advanced stages.
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What happens during stage 2 differs based on the location of the disease.
This is the most common form of the disease, affecting the lining of the lung and chest cavity. Doctors stage this cancer on the Brigham system, the Butchart system, or the TNM system.
The TNM system has become the most widely used for staging pleural mesothelioma. It factors in the size and extent of tumors, lymph node involvement, and the overall spread of cancer throughout the body.
The TNM scale describes stage 2 mesothelioma as:
Peritoneal mesothelioma occurs in the abdominal cavity and is relatively rare. It is generally staged using the Peritoneal Cancer Index (PCI), which assigns a score based on the spread and extent of the cancer present in the abdomen. Lower scores reflect less aggressive, more treatable cancers. Stage 2 patients usually have a PCI score between 11 and 20.
Pericardial mesothelioma affects the lining of the heart and accounts for less than 5 percent of all cases. As a result, this form of cancer does not have a formal staging system, though doctors can use the American Joint Committee on Cancer (AJCC) staging scale. However, because it’s so aggressive, this cancer is often diagnosed in advanced stages or posthumously (after death).
At stage 2, symptoms may become more prevalent than in stage 1 but still remain relatively mild.
Stage 2 symptoms include:
Survival rates for any form of cancer are determined by using statistics based on other patients’ survival times after their initial diagnosis.
Patients with stage 2 have a life expectancy of 19 months on average. However, because it’s such a rare form of cancer, research is limited, and every case is unique. Survival rates also vary by histologic subtypes. Some genetic factors may alter the overall prognosis of the patients. Emerging treatments also offer patients hope for extended life spans.
For patients healthy enough to undergo treatment, cancer may be treated with a multimodal treatment plan that includes surgery supplemented with chemotherapy, radiation, or immunotherapy.
Clinical trials may also be a treatment option for eligible patients. Researchers conduct clinical trials to learn more about a disease and test new treatments before they are approved by the Food and Drug Administration (FDA).
Our team of authors collaborates with the advocate team, focusing on writing about asbestos exposure and mesothelioma to spread awareness. They are dedicated to supporting families within the mesothelioma community.
Dr. Muaiad Kittaneh, MD, FACP, MBA, is a medical oncologist and assistant professor at Loyola University of Chicago. His journey in healthcare includes Internal Medicine training at Advocate Christ Medical Center/University of Illinois of Chicago, where he excelled as Chief Resident. Dr. Kittaneh further honed his expertise at the University of Miami.
Dr. Kittaneh has conducted extensive research and assisted in many clinical trials. His notable contributions have been published in journals across the United States, which focus particularly on breast, melanoma, and gastrointestinal cancers. As an expert medical reviewer, Dr. Kittaneh plays a crucial role in shaping and evaluating Mesothelioma Hub’s content, ensuring accuracy and relevance in the field.
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