How Is Mesothelioma Treated?
The two categories of mesothelioma treatment:
- Curative treatment can potentially extend a patient’s life expectancy.
- Palliative treatment is mainly used to manage symptoms and reduce discomfort.
Primary Mesothelioma Treatment Options
There are specific cancer treatment options for malignant mesothelioma that doctors recommend to help patients live longer.
The main types of curative treatment are:
Mesothelioma specialists will often prescribe multimodal therapy (a combination of two or more mesothelioma treatments). These customized cancer treatment plans are designed to help patients live as long as possible.
Find top specialists who can treat your mesothelioma with our Free Doctor Match service.
Factors Affecting Mesothelioma Treatment
Doctors will consider several factors when determining a patient’s mesothelioma prognosis and treatment plan.
Factors that may impact treatment include:
- Cancer stage at diagnosis
- Cell type
- If (and how fast) the cancer is spreading
- Overall health of the patient
- Type of mesothelioma (pleural, peritoneal, pericardial, or testicular)
Additionally, doctors may rule out certain mesothelioma cancer treatments based on a patient’s age, health, and/or ability to tolerate potential side effects.
Mesothelioma Surgery
In many cases, surgery is one of the best treatments for mesothelioma. Surgery can help stop tumor growth and extend a patient’s lifespan, particularly when the cancer is caught early.
Doctors have developed several mesothelioma surgeries to help patients. The main goal of mesothelioma surgery is to remove all visible tumors and, in some cases, surrounding tissues or infected organs.
Your specific cancer treatment plan will depend on where your mesothelioma is located, its cell type, and its stage of progression.
Registered Nurse Amy Fair discusses standard mesothelioma treatments and how patients can pick the best option. Call (866) 608-8933 today to connect with Amy and get your medical questions answered. View Transcript.
Duration: 2 min 01 sec
What do I need to know about mesothelioma treatments?
It’s really important for your doctors, your oncologists, your surgeons to explain to you what stage you’re in – to explain to you what type of mesothelioma you have. You have to understand your disease, you have to understand the type of disease, and you have to understand the stage of the disease. Many people have to make decisions as far as quality and quantity of life.
What are my treatment options for mesothelioma?
The standard treatment options for mesothelioma is a surgical approach. In pleural mesothelioma, they will offer the patient a pleural decortication where they strip the lining of the lung. They may offer to the patient a pneumonectomy and that is removing the whole lung, not just the lining. They may offer radiation to shrink the tumor first. Also, radiation gives them palliative care if that tumor is pressing on vital organs or nerves and causing pain, they may want to go in and do radiation first to shrink that tumor. Then of course there is the chemotherapy approach, and again sometimes multiple modalities are used. Surgical approach, radiation, and chemotherapy. It is a clinical individual fit for that particular person.
How can I decide what treatment is best for me?
When deciding what treatment modality is best for you it’s important to communicate with your surgeon, to communicate with your oncologist. You need to get an understanding on their thoughts if you’re a candidate for chemotherapy. Are you a candidate to have surgery? Although all that is very important, the individual decision for what type of therapy lies within the mesothelioma patient.
Pleural Mesothelioma Surgery
Malignant pleural mesothelioma develops in the pleura (lining of the lungs). The type of pleural mesothelioma surgery your doctor recommends will depend on your diagnosis.
The two most common types of pleural mesothelioma surgery are:
- Extrapleural pneumonectomy (EPP): Removes all visible tumors, the entire diseased lung, as well as portions of the parietal (outer) pleura, the diaphragm, and the pericardium (heart lining).
- Pleurectomy with decortication (P/D): Removes visible tumors, the diseased parietal pleura, the diaphragm, part of the pericardium, and some lung tissue if necessary. Neither lung is removed.
Studies show that patients who undergo either surgery have similar median survival times. The median life expectancy of patients who receive an EPP is 35.6 months, while patients have a median life expectancy of about 34 months after undergoing a P/D.
A P/D allows patients to keep both lungs, providing them with a better quality of life after surgery. Further, P/D patients typically develop fewer complications than EPP patients.
The American Cancer Society (ACS) considers an EPP to be the more extensive procedure. However, some doctors argue that a P/D does not allow for as much of the cancer to be removed compared to an EPP.
Peritoneal Mesothelioma Surgery
Cytoreduction in combination with hyperthermic intraperitoneal chemotherapy (HIPEC) is the gold standard in treating malignant peritoneal mesothelioma (which forms in the abdominal lining).
Cytoreduction with HIPEC combines surgery with heated chemotherapy in a two-part procedure:
- Cytoreductive surgery removes the peritoneum (lining of the abdominal cavity) and any tumors or diseased tissue nearby.
- Doctors then apply heated chemotherapy drugs into the abdomen for up to 90 minutes to kill any cancer left behind.
The average life expectancy for peritoneal mesothelioma patients who receive cytoreduction with HIPEC is 53 months. Some of those who received this cancer treatment became mesothelioma survivors, living for decades after their diagnosis.
Use our Free Doctor Match to connect with top mesothelioma surgeons in your area.
Mesothelioma Chemotherapy
During chemotherapy, patients are given cancer-killing medications that shrink and slow the growth of tumors. Chemotherapy drugs are used to treat pleural, peritoneal, and sometimes pericardial mesothelioma (which affects the lining of the heart). Chemotherapy can be administered in combination with mesothelioma surgery and immunotherapy to maximize the effectiveness of these treatments and improve patient outcomes.
“Chemotherapy is the most common type of systemic therapy used for mesothelioma. It usually works by keeping the cancer cells from growing, dividing, and making more cells.”
– American Society of Clinical Oncology
Patients are usually given a combination of the chemotherapy drugs cisplatin and pemetrexed. Chemotherapy may be administered before (neoadjuvant), during, after (adjuvant), or in place of surgery.
Mesothelioma Radiation Therapy
Mesothelioma radiation therapy uses electrons or proton beams to destroy cancer cells by damaging their DNA.
The two main types of mesothelioma radiation are:
- Brachytherapy: This internal radiation therapy works by inserting a radioactive device inside a patient’s tumor, allowing higher doses of radiation to target more specific places than EBRT.
- External beam radiation therapy (EBRT): This is the most common of the two types of radiation therapy and is administered through the skin from outside the body.
With radiation, the 2-year survival rate is 58% for pleural mesothelioma, according to a 2019 study by the European Society for Radiotherapy and Oncology.
Radiation therapy can be used before, during, or after surgery or chemotherapy.
Mesothelioma Immunotherapy
Immunotherapy boosts a patient’s immune system so the body can better fight mesothelioma. Immunotherapy medications can be used in combination with various treatments including surgery, chemotherapy, and radiation therapy.
In 2020, the U.S. Food and Drug Administration (FDA) approved two immunotherapy drugs, Opdivo® (nivolumab) and Yervoy® (ipilimumab), to treat pleural mesothelioma after trials showed they helped patients live longer.
This marked the first drug regimen approved for mesothelioma in 16 years. Other mesothelioma immunotherapy medications are currently being studied as well.
Clinical Trials and Emerging Treatments for Mesothelioma
Outside of standard treatment, researchers continue to study new and possibly more effective options for treating mesothelioma. Many of these newer therapies are only available through mesothelioma clinical trials until they are approved for wider use.
Patients who are not responding to standard treatment can ask their care team if they can enroll in a clinical trial. Learn about new and emerging treatment methods below.
Cryotherapy
Cryotherapy (also called cryosurgery) uses liquid nitrogen to freeze and destroy mesothelioma cells. This minimally invasive surgery has been used to treat other types of cancer for decades and has shown some success as a mesothelioma treatment.
Dr. Robert Cameron has been instrumental in testing cryotherapy as an emerging treatment for malignant mesothelioma at UCLA Medical Center.
Patients may undergo cryotherapy before a major surgery to shrink mesothelioma tumors and make them easier to remove. Cryotherapy can also be used to treat mesothelioma recurrences or control symptoms.
Gene Therapy
Gene therapy modifies the DNA of existing cells to fight cancer. This therapy inserts new genes into mesothelioma cells so the body can destroy cancer cells.
In 2022, a team of doctors in Japan created inhalable versions of two gene therapy drugs for non-small cell lung cancer and pleural mesothelioma. Their study found that inhaling the medications — similar to using an asthma inhaler — delivers them directly to the lung in a less invasive way than traditional treatments.
Photodynamic Therapy
Photodynamic therapy uses high-intensity light to activate the body’s immune response and destroy cancer cells. This therapy is usually more effective in localized mesothelioma cases rather than widespread cancer.
Photodynamic therapy is typically performed in an outpatient setting, according to the National Cancer Institute (NCI). This means patients can usually go home after treatment without needing to be hospitalized.
Since photodynamic therapy is typically performed in an outpatient setting, patients can usually go home after treatment without needing to be hospitalized.
Targeted Therapy
Mesothelioma targeted therapy is an advanced treatment approach specifically designed to fight this type of cancer. Unlike traditional treatments like chemotherapy, which can affect healthy cells along with cancerous ones, targeted therapy focuses on attacking cancer cells directly while minimizing harm to healthy tissues.
Targeted therapy is administered through oral medications or intravenous infusions. It is important to note that not all patients with mesothelioma are eligible for targeted therapy — it depends on individual factors such as the stage of the disease and the presence of specific genetic markers.
Tumor Treating Fields
Tumor treating fields (TTFields) use harmless electrical pads to stop mesothelioma from spreading. The pads’ electrical fields interrupt the cancer cells’ ability to divide.
The FDA approved TTFields for treating pleural mesothelioma in 2019. However, patients who receive this new treatment for mesothelioma must also undergo chemotherapy.
Find a mesothelioma doctor today to learn if you’re eligible for clinical trials and emerging treatments.
Palliative Mesothelioma Treatment
Palliative mesothelioma care helps improve patients’ quality of life who undergo aggressive treatments and those unable to receive curative treatment.
Common types of palliative mesothelioma treatment include minor surgeries, low doses of chemotherapy or radiation therapy, pain medications, and alternative therapies.
Common Palliative Surgeries for Mesothelioma
The goal of palliative surgery is to ease symptoms of mesothelioma like chest or abdominal pain, weakness, and shortness of breath.
Palliative mesothelioma surgeries include:
- Paracentesis: This drains fluid in the lining of the abdominal wall and the lining surrounding the internal organs to reduce peritoneal mesothelioma symptoms.
- Partial pleurectomy: Doctors surgically remove part of the pleura (lung lining) so fluid can’t fill it. Fluid buildup in the pleura is a common cause of discomfort in pleural mesothelioma patients.
- PleurX catheter: A catheter can also be inserted into the pleural space if a patient suffers from pleural effusions (fluid buildup in the chest wall) that keep coming back. Patients can then drain the fluid at home instead of going to the hospital.
- Thoracentesis: Doctors use a needle to drain pleural effusions so patients can breathe easier and maintain oxygen levels.
- Video-assisted thoracoscopic surgery (VATS) talc pleurodesis: The space between the two layers of the pleura is sealed with medical-grade talc so that it can no longer fill with fluid.
Many patients who receive palliative mesothelioma treatments can still undergo more aggressive treatments like curative surgery and chemotherapy to hopefully live longer.
Other Palliative Mesothelioma Treatments
Patients who don’t qualify for surgery may be able to seek other forms of symptom-relieving treatment.
Non-surgical palliative care options for mesothelioma include:
- Alternative treatment: Acupuncture, yoga, meditation, and exercise have helped some patients reduce stress and improve their overall well-being. These are not a replacement for professional medical care but can be used alongside traditional therapies.
- Chemotherapy/radiation: In addition to serving as potentially curative treatments, chemotherapy and radiation therapy can also decrease pain by shrinking tumors that are pressing on bones, nerves, or major blood vessels.
- Pain medication: Patients may be able to use over-the-counter drugs to treat mild to moderate pain. Doctors may recommend a prescription medication like steroids or opioids for more severe pain.
How Nutrition Affects Mesothelioma Treatment
A patient’s diet and nutrition can greatly impact mesothelioma treatments. Top mesothelioma doctors can work with patients to ensure they get the proper nutrients they need before, during, and after their cancer treatment.
According to the Mesothelioma Applied Research Foundation, doctors will typically assess a patient’s diet before treatments begin and monitor how their nutritional needs change over time.
For example, some patients may need to increase their calorie intake to avoid losing muscle mass. Other patients might need to limit their fluid intake if they have fluid buildup in the linings of their abdomen or lungs.
Some mesothelioma treatment centers have on-staff dietitians to help patients manage their nutrition.
Mesothelioma Doctors and Cancer Centers
Top mesothelioma doctors specialize in the diagnosis and treatment of mesothelioma and have years (often decades) of experience helping patients diagnosed with this rare cancer.
Leading doctors who treat mesothelioma include:
Dr. Robert Cameron
25+ years of experienceChief of the Division of Thoracic Surgery at the West Los Angeles VA Medical Center
Dr. Jacques Fontaine
15+ years of experienceDirector of the Mesothelioma Research and Treatment Center at H. Lee Moffitt Cancer Center
Dr. Hedy Lee Kindler
25+ years of experienceDirector of the Mesothelioma Program at the University of Chicago Comprehensive Cancer Center
Dr. Raja Flores
20+ years of experienceChairman for the Department of Thoracic Surgery at Mount Sinai Hospital
The doctors listed above and many others treat patients at top mesothelioma cancer centers located across the country.
Leading cancer centers that treat mesothelioma include:
Baylor College of Medicine Lung Institute
Houston, TX
Dr. Taylor Ripley
- Has a robust clinical trials program testing new and promising therapies
- Home to the Mesothelioma Treatment Center founded by the late Dr. David Sugarbaker
Brigham and Women’s Hospital (BWH)
Boston, MA
Dr. Raphael Bueno
- Birthplace of the extrapleural pneumonectomy (EPP)
- Home of the International Mesothelioma Program, one of the most comprehensive mesothelioma cancer research programs in the world
H. Lee Moffitt Cancer Center
Tampa, FL
Dr. Jacques Fontaine
- Home to the Mesothelioma Research and Treatment Center
- Tailors treatment approaches to each patient using the expertise of a multidisciplinary team
Washington Cancer Institute
Washington, DC
- Offers specialized treatment for peritoneal mesothelioma patients
- Home of the Peritoneal Surface Malignancies Program dedicated to treating rare abdominal cancers
Veterans who have been diagnosed with mesothelioma can also receive specialized care at VA treatment centers managed by the U.S. Department of Veterans Affairs (VA). These centers are located across the country and are staffed by highly trained doctors and surgeons like Dr. Cameron and others.
Mesothelioma Treatment Costs
Many patients have questions about how much their mesothelioma treatment will cost. Unfortunately, mesothelioma can be costly without financial support.
Between scans, chemotherapy, and surgical procedures, the estimated cost to treat mesothelioma can easily exceed $400,000.
*Based on the average costs for 1 year of mesothelioma treatment. Costs can vary depending on insurance coverage, location, hospitalization, type of cancer treatment and/or diagnostic testing, and other factors.
Legal Help for Mesothelioma Treatment Costs
One of the best ways to get help paying for mesothelioma treatment is by exploring your legal options.
With help from a legal team, you may qualify for millions of dollars in mesothelioma compensation, which can go toward your medical expenses and protect your family if you pass away. Top mesothelioma attorneys will do all they can to secure money for treatment, transportation, and other expenses.
Find Mesothelioma Treatment Near You
Curative and palliative mesothelioma treatments may help to relieve symptoms, kill cancer cells, and improve your life expectancy.
Many mesothelioma treatment options are available to fight this deadly asbestos-related cancer. Top doctors can determine which treatments work best for your diagnosis and recommend follow-up or supportive care as needed.
Find a mesothelioma doctor today to start the treatment you need to become a survivor.
Mesothelioma Hope has no affiliation with and is not endorsed or sponsored by any of the doctors listed above. The contact information above is listed for informational purposes only. You have the right to contact these mesothelioma specialists directly.
Common Questions About Mesothelioma Treatment
What is the first line treatment for mesothelioma?
The first line treatment for mesothelioma involves a combination of different procedures that may include surgery, chemotherapy, and radiation therapy. Your specific treatment plan depends on factors like the stage of the cancer, tumor location, your age, overall health, and personal preferences.
What is the best treatment for mesothelioma?
The best way to treat mesothelioma will depend primarily on the type and stage of your cancer.
Your mesothelioma doctor and health care team will work with you to determine the best course of treatment based on the risks, side effects, and potential benefits.
Contact us at (866) 608-8933 if you need help finding a specialist to treat you or a family member.
Can you be cured of mesothelioma?
There’s not an official cure for mesothelioma at this time, but long-term survival may be possible. Some patients have lived for 25 years or longer with treatment.
Researchers are also studying new forms of treatment in the hope that we may someday cure mesothelioma.
In the meantime, patients can seek different treatment options to help them live longer. Learn more about how you can access life-extending treatment by contacting our Patient Advocates.
What is the life expectancy of a person with mesothelioma?
Most patients live 12-21 months after being diagnosed with mesothelioma. How long you live after diagnosis can depend on your mesothelioma location, cell type, age, and overall health.
Treatment methods such as surgery, chemotherapy, radiation therapy, and immunotherapy may help you live longer.
Are there any new treatments for mesothelioma?
Yes. New treatment options often come from clinical trials conducted at top cancer centers. During mesothelioma clinical trials, doctors test new therapies with the hopes of curing this cancer.
Examples of emerging treatments for malignant mesothelioma include virotherapy, which uses genetically or naturally produced viruses to directly infect tumor cells, and epigenetic therapy, which alters the expression of genes to eliminate malignant cells.
