Stage 1 Mesothelioma

Stage 1 is the earliest point in mesothelioma’s development. During this stage, the cancer has not spread beyond the lining of the lungs or abdomen. Stage 1 mesothelioma patients have the best prognosis and are usually good candidates for life-extending surgeries and other treatments. Learn more about stage 1 mesothelioma and treatment below.

Fact-Checked and Medically Reviewed By: Dr. Mark Levin

What Is Stage 1 Mesothelioma?

Stage 1 mesothelioma is the earliest of mesothelioma’s four stages. These stages come from the tumor-node-metastasis (TNM) staging system — a globally recognized method for determining how far a patient’s cancer has spread.

Stage 1 mesothelioma may refer to two types of mesothelioma:

  • Pleural mesothelioma: Malignant (cancerous) pleural mesothelioma is the only officially-staged type, using the TNM cancer staging system. At this stage, the cancer is only on one side of the chest and remains in the lining of the lung tissues. It has not yet spread to nearby lymph nodes or to distant parts of the body.
  • Peritoneal mesothelioma: Peritoneal mesothelioma may be unofficially categorized as stage 1 using a modified TNM staging system proposed by medical professor Tristan D. Yan and his associates. This staging system isn’t used by all doctors, however. At stage 1, peritoneal mesothelioma has not spread past the lining of the abdomen.

Doctors don’t know enough about pericardial mesothelioma and testicular mesothelioma to properly stage them since they are so rarely diagnosed. These types of mesothelioma may instead be described as localized, regional, or distant (the LRD staging system). Pericardial and testicular mesothelioma may also be simply categorized as early or advanced.

Compared to later stages, there are a greater number of treatment options available for patients with stage 1 mesothelioma, including curative (life-extending) surgery. Symptoms in stage 1 are less advanced than later stages and are easier to control and manage.

Check out our Free Mesothelioma Guide to get comprehensive information on symptoms, treatment, and much more.

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Quick Facts About Stage 1 Mesothelioma
  • A 2017 study published in Lung Cancer International found that only 16% of pleural mesothelioma and 5% of peritoneal mesothelioma patients were diagnosed during stage 1.
  • Few patients are diagnosed at stage 1 because symptoms may not be present or be too mild to cause concern.
  • Multimodal therapy, which uses a combination of surgery, chemotherapy, and radiation, is the recommended treatment for stage 1 mesothelioma.
  • American Cancer Society (ACS) data shows that 20% of patients diagnosed with localized (early-stage) pleural mesothelioma survive at least 5 years after diagnosis.

How Stage 1 Mesothelioma Develops

Mesothelioma is known for its long latency period — the time that passes between being exposed to a cancer-causing substance and when symptoms first appear. After a patient is exposed to asbestos, the main cause of malignant pleural mesothelioma, it can take 10-50 years for systems to present.

Close-up of construction materials made with asbestos fibers

Stage 1 mesothelioma develops after asbestos fibers get stuck in the lining of the lungs (pleura) or abdomen (peritoneum). These fibers irritate nearby cells, eventually damaging DNA and triggering out-of-control cell growth. This unchecked growth forms tumors on the lining of the organs.

The TNM staging system describes stage 1 pleural mesothelioma’s development using sub-stages.

Stage 1 pleural mesothelioma has two sub-stages of development:

  • Stage 1A: Stage 1A of the TNM staging system describes a pleural mesothelioma diagnosis in which cancer is only on one side of the chest, remaining only in the thin membrane covering the chest cavity. It has not yet reached the lung lining.
  • Stage 1B: Stage 1B is slightly more advanced, describing pleural mesothelioma that remains localized to one side of the chest, but that has spread to the pleura as well as the chest wall lining.

As stage 1 mesothelioma develops, it can begin to cause vague symptoms that may be difficult to identify as signs of mesothelioma.

Stage 1 Mesothelioma Symptoms

Many patients do not experience any mesothelioma symptoms during the earliest stage of the disease.

However, some patients may experience the following mesothelioma stage 1 symptoms:

  • Body aches
  • Chest pain
  • Dry, persistent cough
  • Fever
  • Shortness of breath
  • Slight difficulty breathing
  • Tightness of the chest

Fluid buildup in the chest (pleural effusions) may begin during stage 1, causing the above symptoms. However, these vague, mild symptoms are often mistaken for less serious illnesses such as a cold, flu, pneumonia, or bronchitis.

Be sure to bring up your symptoms with a doctor as soon as possible to prevent a misdiagnosis. The earlier mesothelioma is diagnosed, the quicker you can begin to receive potentially life-extending treatment.

How to Identify Stage 1 Mesothelioma

Most mesothelioma patients have no symptoms very early into the disease’s progression, making it extremely difficult to identify stage 1 mesothelioma without medical equipment.

Stage 1 mesothelioma is usually discovered by accident in the course of doing tests for another medical issue or as part of regular cancer screening for a high-risk patient.

Patients can increase their chances of catching mesothelioma early by telling their doctor about any history of asbestos exposure. Download our Free Questions to Ask Your Doctor Checklist so you can feel fully prepared at your appointment.

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Stage 1 Mesothelioma Diagnosis

Doctors rarely make a mesothelioma diagnosis at stage 1 because patients either experience no symptoms or vague symptoms. This is because the tumor hasn’t spread yet, so the more severe symptoms haven’t started.

Even when someone with mesothelioma happens to get an imaging test done, the small stage 1 mesothelioma tumor may be hard to see.

However, these two features may alert doctors to stage 1 mesothelioma on imaging tests:

  • Abnormal tissue masses in the chest area
  • Pleural effusions

Seeing either of these in a chest X-ray may prompt a mesothelioma doctor to investigate further and perform a biopsy, hopefully leading to an early diagnosis.

Stage 1 Diagnosis and Staging Systems

When doctors are able to confirm that a patient has mesothelioma, they use a staging system to determine how far the disease has progressed.

Today, the most widely accepted mesothelioma staging system is the TNM system.

However, other systems exist, each with their own way of describing stage 1 or early-stage pleural mesothelioma.

Stage 1 Pleural Mesothelioma Diagnosis by Staging System

  • Brigham system: The disease can be surgically removed and has not yet spread to the lymph nodes.
  • Butchart system: The disease remains contained in the pleura.
  • TNM system: The disease remains on one side of the chest in the lining of the chest wall. The pleura may be cancer-free (1A) or cancer may have spread to the pleura (1B).

While the Brigham system is not often used anymore, the Butchart system remains popular in some parts of the world.

Stage 1 Mesothelioma Prognosis

A mesothelioma prognosis describes the likely course the disease will take. Patients diagnosed with stage 1 pleural mesothelioma have a better prognosis than late-stage patients, meaning they have a longer life expectancy based on higher survival rates.

As the earliest stage, stage 1 mesothelioma has the most treatment options. Catching the disease in its earliest stage allows doctors to provide treatments which can greatly extend your lifespan.

Stage 1 Mesothelioma Life Expectancy

Life expectancy describes the average amount of time a patient can expect to live after being diagnosed. Naturally, patients diagnosed during stage 1 have the longest life expectancy of all four mesothelioma stages.

Mesothelioma stage 1 life expectancy is 12 months on average.

Stage 1 Mesothelioma Survival Rates

Mesothelioma survival rates measure the percentage of people with the disease who survive for a certain number of years after diagnosis.

As with life expectancy, patients diagnosed with stage 1 mesothelioma can expect comparatively high survival rates.

The tables below reflect mesothelioma life expectancy data from a 2017 study published in Lung Cancer International. Taken from over 11,000 patients from 1973–2011, it shows how the stage at diagnosis affects survival rates.

The study translated the TNM staging system into the LRD system in the following way:

  • Localized: Stage 1 mesothelioma
  • Regional: Stage 2, 3, and 4 mesothelioma that has not spread to distant body parts
  • Distant: Advanced stage 4 mesothelioma that has spread to other parts of the body

This translation was applied to both pleural and peritoneal mesothelioma.

Survival Rates for Pleural Mesothelioma by Stage

Mesothelioma Stage1-Year Survival Rate5-Year Survival Rate
Localized41%6%
Regional40%4%
Distant32%3%

Survival Rates for Peritoneal Mesothelioma by Stage

Mesothelioma Stage1-Year Survival Rate5-Year Survival Rate
Localized74%26%
Regional55%19%
Distant40%11%

Stage 1 mesothelioma patients live longer, in part, because their early diagnosis allows them to seek critical life-extending treatment that may be unavailable to later-stage patients.

Stage 1 Mesothelioma Treatment

Stage 1 mesothelioma patients are usually good candidates for curative mesothelioma treatments — medical procedures performed to extend a patient’s life.

Stage 1 Mesothelioma Surgery

In general, stage 1 patients are good candidates for mesothelioma surgery. At this stage, surgeons are usually able to completely remove all visible parts of a tumor.

Studies show that patients who receive surgery during stage 1 of pleural mesothelioma have survival rates between 10-24 months, although some patients have survived much longer.

However, many factors may influence whether a patient is a candidate for surgery:

  • Cell type: Many doctors believe only epithelioid and mixed/biphasic cell types may be appropriate for resection (surgical removal of cancer tumors).
  • Location: Tumors that form close to vital organs may be too risky to remove through surgery.
  • Patient health: Surgery for mesothelioma can be dangerous and difficult on the body. Even if a patient is diagnosed early, if they are in poor health, surgery may not be offered if it would be unsafe.
  • Stage: Tumors that are relatively small and contained in one area (localized) are more likely able to be surgically removed.

Common stage 1 mesothelioma surgery options include:

Although surgery is often effective for stage 1 patients, it may leave behind cancer cells that are not visible to surgeons. These cells quickly re-form tumors. As such, most doctors will also recommend chemotherapy or radiation to destroy the remaining cancer.

Did You Know?

According to 2018 study, patients who had their stage 1 mesothelioma tumors removed with EPP had a median survival time of 40 months, whereas those managed by P/D had a median survival time of 23 months.

Stage 1 Mesothelioma Chemotherapy

Chemotherapy, a type of cancer treatment that uses special drugs to kill cancer cells, is often used alongside surgery in stage 1 mesothelioma treatment plans.

Chemotherapy may be used for stage 1 mesothelioma treatment to:

  • Prevent mesothelioma cells from spreading before, during, or after surgery
  • Kill off remaining cancer cells left behind after surgery

Many patients respond well to a combination of surgery and chemotherapy, potentially remaining disease-free for several months and surviving for years after treatment.

Stage 1 Mesothelioma Radiation Therapy

Radiation, a therapy that uses radiation to control or kill cancer cells, is sometimes used to treat mesothelioma.

Radiation therapy may be used for stage 1 mesothelioma treatment to:

  • Kill remaining cells at the tumor site after surgery
  • Prevent mesothelioma cells from being spread around the body during surgery
  • Shrink tumors to make surgery easier

Before performing an EPP, mesothelioma specialists often use a practice called Surgery for Mesothelioma After Radiation Therapy (SMART). This approach seems to be effective at extending patient life.

A study published in the Journal of Thoracic Oncology found that 84% of patients with pleural mesothelioma epithelial cell type who underwent SMART had a 3-year survival rate.

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Other Treatment Options for Stage 1 Mesothelioma

Stage 1 mesothelioma patients in good health usually turn to traditional treatment options to get the best results.

However, not all patients diagnosed early are good candidates for curative treatment options. These individuals may be able to benefit from mesothelioma clinical trials and the emerging therapies they offer in hopes of extending their survival time.

Some emerging mesothelioma treatments include:

To learn more about clinical trials and emerging therapies, get your copy of our Free Mesothelioma Guide.

Localized vs. Advanced Stages of Pleural Mesothelioma

When comparing stage 1 pleural mesothelioma to its later stages, the primary difference is how much the mesothelioma has spread. This process of tumor spreading is known as mesothelioma metastasis.

Stage 1 is still considered localized, meaning the tumor is contained to the part of the body where it started. With pleural mesothelioma, this means it’s contained in one of the layers of the pleura, the thin, doubled-lined layer that covers and protects the chest cavity.

In the more advanced stages of mesothelioma, the tumors spread to other parts of the body.

Improving Your Stage 1 Mesothelioma Prognosis

Doctor speaking to a patient about stage 1 mesothelioma

The rare patient who receives a stage 1 mesothelioma diagnosis has an advantage when it comes to treatment options. However, even when caught in its earliest stages, mesothelioma is an aggressive disease with a poor overall prognosis.

Patients should give themselves every advantage when fighting mesothelioma to get the best prognosis possible.

Stage 1 mesothelioma patients may work toward a better prognosis by:

  • Eating well: Many peritoneal mesothelioma patients may struggle to meet their nutritional needs as their cancer progresses. However, getting the right nutrition boosts the immune system, giving patients undergoing treatment for any type of mesothelioma the best chance of survival and recovery.
  • Exercising: Exercise may decrease stress, improve blood flow, and help prevent bedsores and other secondary health problems.
  • Managing stress: High stress levels may affect overall health and patient recovery from treatments.
  • Not smoking: Smoking decreases overall patient health, making it harder — or impossible — to undergo and recover from invasive treatments. Smoking may also lead to another cancer diagnosis, decreasing life expectancy.
  • Seeking life-extending treatment: Many mesothelioma victims are diagnosed late in their cancer progression, leaving them unable to undergo aggressive treatments that may extend their lives by several months or even years. Patients diagnosed early should take advantage and seek curative treatments while they are able.

Get Help With Treatment for Stage 1 Mesothelioma

Doctors are studying current and new treatment options daily. Emerging cancer treatment options may soon give mesothelioma patients far better survival rates or even a cure.

Treatments at any stage can improve life expectancy and quality of life. Talk to your health care team about what you can do to improve your prognosis, including seeking a second opinion and participating in clinical trials.

Use our Free Doctor Match to get connected with top mesothelioma specialists in your area.

Stage 1 Mesothelioma FAQs

Is stage 1 mesothelioma curable?

No. There is not yet a cure for mesothelioma. However, the medical community continues to research new ways to treat this cancer through clinical trials in the hopes that it can one day be cured.

What is the stage 1 mesothelioma survival rate?

For stage 1 mesothelioma, the 2-year survival rate is 45%, and the 5-year survival rate is 16%.

These are the percentages of patients who are still alive for at least 2 and 5 years, respectively, after being diagnosed with stage 1 mesothelioma.

Reviewed by:Dr. Mark Levin

Certified Oncologist and Hematologist

  • Fact-Checked
  • Editor

Mark Levin, MD has over 30 years of experience in academic and community hematology and oncology. In addition to serving as Chief or Director at four different teaching institutions throughout his life, he is also still a practicing clinician, has taught and designed formal education programs, and has authored numerous publications in various fields related to hematology and oncology.

Dr. Mark Levin is an independently paid medical reviewer.

  • Board Certified Oncologist
  • 30+ Years Experience
  • Published Medical Author
Written by:

Lead Editor

Laura Wright is a journalist and content strategist with more than 14 years of professional experience. She attended college at the University of Florida, graduating magna cum laude with a bachelor’s degree in journalism in 2008. Her writing has been featured in The Gainesville Sun and other regional publications throughout Florida.

11 References
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  2. Mott F. E. (2012). Mesothelioma: a review. The Ochsner journal, 12(1), 70–79. Retrieved December 2, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3307510/

  3. The American Cancer Society medical and editorial content team. (2018). Malignant Mesothelioma Stages. Retrieved December 2, 2022, from https://www.cancer.org/cancer/malignant-mesothelioma/detection-diagnosis-staging/staging.html

  4. Mayo Clinic Staff. (2019). Mesothelioma: Diagnosis & treatment. Retrieved December 2, 2022, from https://www.mayoclinic.org/diseases-conditions/mesothelioma/diagnosis-treatment/drc-20375028

  5. National Organization of Rare Disorders. (2017). Mesothelioma. Retrieved December 2, 2022, from https://rarediseases.org/rare-diseases/mesothelioma/

  6. Faig, J., Howard, S., Levine, E. A., Casselman, G., Hesdorffer, M., & Ohar, J. A. (2015). Changing pattern in malignant mesothelioma survival. Translational oncology, 8(1), 35–39. Retrieved December 2, 2022, from doi:10.1016/j.tranon.2014.12.002

  7. Amin, W., Linkov, F., Landsittel, D. P., Silverstein, J. C., Bashara, W., Gaudioso, C., … Becich, M. J. (2018). Factors influencing malignant mesothelioma survival: a retrospective review of the National Mesothelioma Virtual Bank cohort. F1000Research, 7, 1184. Retrieved December 2, 2022, from doi:10.12688/f1000research.15512.3

  8. Kim, J., Bhagwandin, S., & Labow, D. M. (2017). Malignant peritoneal mesothelioma: a review. Annals of translational medicine, 5(11), 236. Retrieved December 2, 2022, from doi:10.21037/atm.2017.03.96

  9. National Cancer Institute. (2015). Cancer Staging. Retrieved December 2, 2022, from https://www.cancer.gov/about-cancer/diagnosis-staging/staging

  10. Shavelle, R., Vavra-Musser, K., Lee, J., & Brooks, J. (2017). Life Expectancy in Pleural and Peritoneal Mesothelioma. Lung Cancer International. Retrieved December 2, 2022, from doi:10.1155/2017/2782590

  11. John Cho, B.C., Feld, R., Leighl, N., Opitz, I., Anraku, M., Tsao, M. … & Perrot, M. (2014). A Feasibility Study Evaluating Surgery for Mesothelioma After Radiation Therapy: The “SMART” Approach for Resectable Malignant Pleural Mesothelioma. Journal of Thoracic Oncology, 9(3), 397-402. Retrieved December 2, 2022, from https://doi.org/10.1097/JTO.0000000000000078

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