Stage 1 Mesothelioma is the early stage of the disease. Patients diagnosed at this stage have the most treatment options and the best prognosis.
Table of Contents
- Stage 1 mesothelioma is limited to one specific area of the body.
- Symptoms are rare or mild and can easily be confused with other common illnesses.
- Treatment is often curative for patients diagnosed at this stage.
- Stage 1 Mesothelioma patients usually live 1.5-3 years after diagnosis.
Mesothelioma stage 1 is the early stage of the disease. The cancer is still localized to one part of the body, like the lining of the lungs, andhas not spread to any nearby organs or lymph nodes. At this stage, patients rarely experience symptoms, making it difficult to diagnose mesothelioma early.
For patients who can be diagnosed at this stage, curative treatment options are available. Stage 1 mesothelioma patients have the best prognosis, with an average survival of 21-40 months.
Stage 1 Mesothelioma By Type
Because the cancer is localized and tumors are generally smaller at this stage, all types of mesothelioma diagnosed at stage 1 have the most affordable treatment options, such as surgical resection. Without metastases and no more treatment options, patients have a life expectancy.
Stage 1 Pleural Mesothelioma
Mesothelioma specialists use three staging systems to characterize pleural mesothelioma, including the Butchart system, the Brigham system, and the TNM system. Although all three describe the cancer in a similar way, many doctors prefer the TNM system because it is frequently updated with thelatest mesothelioma information. The TNM system notes the size and location of the tumor, any lymph node involvement, and the degree of metastasis.
According to the latest publication, researchers have updated the description of the first stage of malignant mesothelioma, characterized by two categories.
Characteristics Of The TNM System Of Stage 1 Mesothelioma
Stage 1A mesothelioma
- Mesothelioma cells are in the pleural layer of the chest wall on one side of the chest
- Tumors can also affect the lung, diaphragm, or mediastinal pleura
- Does not spread to nearby lymph nodes or distant organs
- May be identified as T1N0M0
Stage 1B mesothelioma
- The tumor can also grow in the first layer of the chest wall, in the fatty tissue of the mediastinum, in the lungs, in the diaphragm or in the pericardium.
- The cancer has not spread to nearby lymph nodes or distant organs
- May be identified as T3N0M0
Stage 1 Peritoneal Mesothelioma
With only 500 cases each year, research on peritoneal mesothelioma is more limited. As such, doctors have not developed specific staging systems for this form of the disease, instead relying on the general characteristics of mesothelioma or the Peritoneal Cancer Index (PCI). When performing PCI, doctors assess the size and number of visible tumors located in 13 different regions of the abdomen. The scores are added together, and the totals represent the stage of the cancer. The researchers gave a score of 1 to 10, indicating the first stage of abdominal cancer.
Because pericardial mesothelioma is rare, there is no widely accepted staging system for this form of cancer.
Stage 1 Mesothelioma Symptoms
Stage 1 mesothelioma tumors are usually small and localized, so symptoms are usually absent or very mild. That is why patients are rarely diagnosed at this stage. Patients with symptoms can easily be mistaken for common illnesses such as the common cold or flu.
Stage 1 Mesothelioma Symptoms
- Chest pain
- persistent cough
- Air failure
- Body aches
Life Expectancy Of Stage 1 Mesothelioma
Because the tumors are localized, stage 1 mesothelioma patients have more treatments and a better prognosis. The average life expectancy with such an early diagnosis is 21-40 months, although some patients can survive 5 years or more.
In addition to early diagnosis, the prognosis for patients varies depending on the type of mesothelioma, cell type, genetics, general health, and the age and gender of the patient. Many of these factors will also affect the treatment options available
Treatment Of Stage 1 Mesothelioma
A mesothelioma specialist will develop a mesothelioma treatment plan based on an individual’s specific case. Mesothelioma is often treated with a combination of treatments, including surgery and chemotherapy. In the early stages of mesothelioma, curative surgery is still an option and often offers the best chance for extended survival.
Mesothelioma surgery is often the only treatment option for patients diagnosed at stage 1 or 2, since the cancer is localized. Many of these surgeries are considered aggressive treatments because they are quite extensive and invasive. Some patients undergo pleurotomy and decortication (PD), which involves removing the pleural lining of the chest. Other patients undergo an extra pleural pneumonectomy (EPP), which involves removing the entire diseased lung along the pleural lining of the chest. Depending on what cancer cells have invaded, part of the diaphragm, chest wall, or pericardium may be removed and also repaired during each of these operations.
These surgeries are often followed by chemotherapy and sometimes radiation therapy to kill any remaining mesothelioma cells.
Chemotherapy alone does not have a high success rate, with studies showing a 5-year survival rate of about 4%. However, with surgery, researchers have seen better results, with some patients surviving longer than 5 years. Clinical trials continue to test new combinations of chemotherapy, as well as chemotherapy with other emerging treatments, such as immunotherapy.
Newer uses of chemotherapy have also seen success, with treatments such as hyperthermia intraperitoneal chemotherapy (HIPEC), which is a heated chemotherapy wash, and pressurized intraperitoneal aerosol chemotherapy (PIPAC), which uses pressurized chemotherapy gas. HIPEC combined with surgery has helped improve 5-year survival rates for peritoneal mesothelioma by more than 50%, with some studies finding survival rates of 67% or higher. PIPAC, although still in its early stages, also showed promise in a recent study, where patients had a median survival of 26.6 months.
A rare individual treatment, radiation therapy is sometimes used to kill cancer cells after surgery and chemotherapy. Patients diagnosed at advanced stages are rarely treated with radiation because it is a localized treatment. Radiation therapy can also cause more serious side effects because the treatment can damage surrounding healthy tissue.
Clinical Trials And Developing Treatments
Immunotherapy and other emerging treatments have shown promise in treating mesothelioma, even for patients with more advanced disease. While immunotherapies such as pembrolizumab have been the focus of many clinical trials and have shown success in extending life expectancy, researchers are also developing new immunotherapies and combinations in early-phase trials.
Personalized cancer vaccines, designed based on a tumor’s individual genetic makeup, have become a larger focus of cancer research. Some early clinical studies have shown that the vaccine may increase the lifespan of mesothelioma by more than 5 years in some patients. Other new forms of immunotherapy, such as immune modulators, are also effective in reducing tumor size and improving overall survival. Researchers hope to soon see some form of immunotherapy become FDA-approved for mesothelioma to increase survival benefits for more patients.