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Pleural Mesothelioma Treatment

Pleural mesothelioma treatment can kill cancer cells, manage symptoms, and increase life expectancy for patients with this cancer. Surgery, chemotherapy, and immunotherapy are just a few options available to help treat malignant pleural mesothelioma. Learn more about your options and let our team connect you with top pleural mesothelioma doctors for treatment.

Fact-Checked and Updated by: Jenna Tozzi, RN

Last updated:

How Do You Treat Pleural Mesothelioma?

Treatment for pleural mesothelioma typically involves a combination of surgery, chemotherapy, and radiation therapy. Immunotherapy may also be an option in certain cases.

Which treatments doctors will use depends on the patient’s overall health, cancer spread, and other factors.

Pleural mesothelioma is an aggressive disease that tends to spread quickly. Waiting too long to pursue mesothelioma treatment can allow the cancer to become more advanced, making it harder to treat effectively.

Illustration of pleural mesothelioma cancer in the lining of the lungs (also known as the pleura)
Illustration of pleural mesothelioma in the lung lining

“Delaying medical treatment of any sort will only make your already challenging situation more difficult or even dire. Every day that you wait or waste is one less day you can fight this disease.”

- Quote from John Panza, 11+ year pleural mesothelioma survivor

Getting treatment as soon as possible after a diagnosis is the best way to improve your life expectancy and work toward becoming a long-term survivor.

Key Facts on Pleural Mesothelioma Treatment

  • Surgeries: Extrapleural pneumonectomy (EPP), pleurectomy/decortication (P/D)
  • Other treatments: Chemotherapy, hyperthermic intrathoracic chemotherapy (HITHOC), radiation therapy, immunotherapy, Tumor Treating Fields, palliative care to relieve symptoms
  • Life expectancy with treatment: 18 months on average, but some patients have lived much longer
  • Doctors who treat pleural mesothelioma: Thoracic surgeons, medical oncologists, and radiation oncologists
  • Financial support for treatment: Asbestos trust fund payouts, mesothelioma settlements, and VA benefits

We can help you find pleural mesothelioma treatment in your area and schedule appointments with top specialists. Use our Free Doctor Match to get started.

Mesothelioma doctor talking with an older couple
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Types of Malignant Pleural Mesothelioma Treatments

Treatment plans depend on the patient’s age, general health, and pleural mesothelioma stage at the time of diagnosis.

Early-stage patients are more likely to tolerate surgery and other aggressive treatments since their cancer hasn’t spread beyond the lung lining. Patients with advanced cancer may only qualify for chemotherapy and palliative care for symptom management.

Your pleural mesothelioma specialist will consider these factors when establishing a cancer care plan that includes one or more of the following treatment options.

Extrapleural Pneumonectomy Surgery

Extrapleural pneumonectomy (EPP) is an aggressive surgical treatment for pleural mesothelioma.

The EPP procedure removes as much cancerous tissue from the body as possible. This includes the affected lung, parts of the diaphragm, heart lining, and nearby lymph nodes if necessary. The goal of the surgery is to prevent the disease from spreading any further.

EPP is most effective when combined with other therapies such as chemotherapy or radiation. These other treatments can shrink tumors so they’re easier to remove before surgery, or help kill microscopic cancer cells left behind after surgery. Patients treated with an EPP, chemotherapy, and radiation therapy live 26.8 months on average.

Doctors often recommend an EPP for patients with early-stage mesothelioma since there’s a better chance of removing all of the cancer. There’s also a lower risk of complications with early-stage patients.

EPP may still be an option for late-stage patients who are otherwise in good health. Cleveland musician John Panza was diagnosed with stage 3 pleural mesothelioma in 2012 but was still able to undergo an EPP, radiation, and chemotherapy.

“I remain in awe of what the human body can endure and still feel ‘normal.’ My body might look like I was stabbed, shot, or lost a fight with a bull, but I keep going. And I continue to enjoy travel, music, teaching, and writing.”

- Quote from John Panza, 11+ year pleural mesothelioma survivor

Pleurectomy With Decortication Surgery

The pleurectomy/decortication (P/D) procedure surgically removes all visible tumors but unlike an EPP, both lungs are kept intact.

Doctors may also remove:

  • The outer pleura (lung lining)
  • Parts of the pericardium (heart lining)
  • The diaphragm (muscle that helps with breathing)
  • Lung tissue

Patients who get P/D surgery have an average life expectancy of 34 months.

P/D has fewer risk factors compared to EPP. This surgery is most effective when combined with other therapies, such as chemotherapy or radiation, to shrink tumors and destroy remaining cancer cells.

Get our Free Mesothelioma Guide to learn more about surgery and other treatments for pleural mesothelioma.

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Post-Surgery Hyperthermic Intrathoracic Chemotherapy

Hyperthermic intrathoracic chemotherapy (HITHOC) is an innovative treatment that complements pleural mesothelioma surgery.

With this treatment, heated chemotherapy drugs are applied to the patient’s chest cavity while they’re undergoing surgery. The heat makes the chemotherapy more effective, allowing for deeper penetration into cancerous tissues. HITHOC targets any cancer cells that weren’t visible during surgery.

HITHOC has been linked to extended survival times, with some patients living up to 35 months post-treatment.

Chemotherapy

Standard mesothelioma chemotherapy is administered through an IV to target and kill cancer cells throughout the body. Chemotherapy can be used before or after pleural mesothelioma surgery and combined with immunotherapy to help patients live longer.

Chemotherapy can also be prescribed for patients in advanced stages of pleural mesothelioma who can’t get surgery. In these cases, it can control the growth and spread of cancerous tumors while managing symptoms. Patients who get chemotherapy are usually given a combination of two drugs: pemetrexed and cisplatin.

John Stahl
Point of Hope

Stage 4 survivor John Stahl got chemotherapy after being diagnosed with pleural mesothelioma in 2019 and says he’s “doing very well” more than 4 years later.

Tumor Treating Fields

Tumor Treating Fields (TTFields) interfere with cancer cells’ ability to multiply and grow. It does this through low-intensity electric fields administered through patches that stick to the chest.

Results from the STELLAR clinical trial showed TTFields combined with chemotherapy helped patients with unresectable (inoperable) pleural mesothelioma live for 18.2 months on average post-treatment.

Immunotherapy

Patient being prepped for immunotherapy

Immunotherapy strengthens the immune system, slows disease progression, and improves life expectancy for some patients.

It’s especially helpful for patients with inoperable pleural mesothelioma whose tumors have spread (or metastasized) beyond the lungs.

The CheckMate 743 clinical trial found that the combination of the immunotherapy drugs Opdivo® (nivolumab) and Yervoy® (ipilimumab) helped patients live 4 months longer compared to those who received chemotherapy.

Pleural mesothelioma patients who received a combination of immunotherapy and (chemoimmunotherapy) had an overall survival time of 20.8 months, according to study results published in the Journal for ImmunoTherapy of Cancer. The patients in the trial were given nivolumab for 4-6 cycles of chemotherapy with pemetrexed and cisplatin.

Radiation Therapy

Radiation therapy, also called radiotherapy, is a common pleural mesothelioma treatment. It involves directing high-energy rays at tumors to shrink them or slow their growth. Radiotherapy can also help manage symptoms like chest pain and shortness of breath.

Radiation therapy can be used alongside complementary treatments like chemotherapy or after early-stage surgery (adjuvant radiotherapy).

It’s also ideal for patients who cannot undergo surgery due to their age, health, or advanced cancer spread.

Use our Free Doctor Match to take the first step toward starting pleural mesothelioma treatment and get in touch with top specialists.

Mesothelioma doctor talking with an older couple
Free Mesothelioma Doctor Match

We'll help you connect with a local mesothelioma specialist for personalized treatment.

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Clinical Trials and Emerging Treatments for Pleural Mesothelioma

Clinical trials can be an option for pleural mesothelioma that won’t respond to conventional treatments.

There are several new mesothelioma treatments that can help improve prognosis and quality of life.

Immunotherapies

New immunotherapies are being studied in mesothelioma clinical trials to see how they can help patients.

Examples of emerging immunotherapies for pleural mesothelioma include:

  • CAR T-cell therapy: Reprograms the body’s T-cells, training them to recognize and attack cancer cells.
  • Checkpoint inhibitors: Slows down proteins that stop the immune system from responding to cancer cells.
  • Lab-made cytokines: Produce chemicals that attract immune cells to the cancerous sites, boosting the body’s defenses.
  • Vaccines: Train the immune system to produce antibodies specifically meant to target and fight cancer cells.

Photodynamic Therapy

During photodynamic therapy (PDT), a specialist administers a light-sensitive drug which gets absorbed by cancer cells. When that special light is applied, the drug activates and kills the cells.

A study led by the University of Pennsylvania found that patients who underwent PDT with pleurectomy/decortication surgery lived an average of 31.7 months. Patients diagnosed with the epithelioid mesothelioma cell type lived even longer — 41.2 months on average.

Pleural Mesothelioma Treatment Doctors

If you’ve received a possible pleural mesothelioma diagnosis, the first step is to find a mesothelioma doctor.

These mesothelioma doctors include medical oncologists, radiologists, and surgeons who specialize in treating this cancer and can build a tailored treatment plan for you or a loved one.

Some of the country’s top pleural mesothelioma specialists are featured below:

Dr. Raja Flores

Dr. Raja Flores

25+ years of experience

Chairman of the Department of Thoracic Surgery at Mount Sinai Medical Center in New York

Dr. Robert Cameron

Dr. Robert Cameron

20+ years of experience

Chief of Thoracic Surgery at West Los Angeles VA Medical Center

Dr. Raphael Bueno

Dr. Raphael Bueno

20+ years of experience

Director of the International Mesothelioma Program at Brigham and Women’s Hospital in Boston

Dr. Taylor Ripley

Dr. Taylor Ripley

15+ years of experience

Director of the Mesothelioma Treatment Center at Baylor College of Medicine’s Lung Institute in Houston

Top Pleural Mesothelioma Cancer Treatment Centers

There are over 100 cancer centers across the country that specialize in treating pleural mesothelioma.

These cancer centers typically offer comprehensive care, including standard treatments, clinical trials, and other supportive services tailored to the needs of pleural mesothelioma patients.

Some of the top pleural mesothelioma treatment centers include:

If you’ve been diagnosed with pleural mesothelioma, you should seek care at medical centers or hospitals that have experience in this specific type of cancer to ensure you get the most effective and appropriate treatments available.

Treating Pleural Mesothelioma Symptoms

Palliative care is crucial in managing late-stage pleural mesothelioma. It focuses on symptom relief and enhancing quality of life rather than curing the disease.

Palliative treatments can help patients undergoing standard treatment and those with advanced cancer that can’t be treated with conventional therapies.

Palliative care options include:

  • Alternative treatment: Pleural mesothelioma alternative treatment can include acupuncture, yoga, meditation, and exercise. Each of these can reduce stress, strengthen the immune system, and improve overall well-being when used with standard therapies.
  • Chemotherapy and radiation: Both treatments can reduce pain by shrinking tumors that may be pressing on the ribs or chest wall. This can ease chest pain and shortness of breath.
  • Pain management: Over-the-counter drugs are used for mild to moderate pain, while more severe pain might require a prescription.
  • Surgical procedures: Talc pleurodesis, thoracentesis, and paracentesis are surgeries that reduce discomfort from pleural effusion (fluid buildup around the lungs).

Pairing Nutrition With Pleural Mesothelioma Treatment

Nutrition plays a key role in the treatment and recovery of pleural mesothelioma patients.

A well-balanced diet, rich in essential nutrients, can make treatments more effective. Nutrition plans for mesothelioma patients help boost the body’s response to treatment and reduce chemotherapy side effects like nausea and loss of appetite.

Patients undergoing treatment are encouraged to eat:

  • Foods with different flavors: To counteract changes in taste due to chemotherapy.
  • Frequent, small meals: To maintain energy and manage malnutrition.
  • Fruits and vegetables: 5-9 servings per day to provide essential nutrients.
  • Room-temperature foods: To reduce nausea aggravated by strong cooking smells.
  • Soft foods: Especially beneficial for those experiencing mouth sores from chemotherapy.

Many insurance plans will cover your visit with a registered dietitian as part of your pleural mesothelioma treatment plan.

Arthur Putt and his wife Jan
Point of Hope

Arthur Putt tried multiple treatments for pleural mesothelioma but saw limited results. After switching to a liquid diet that included key nutrients, he was able to reduce his side effects and strengthen his immune system. He is still thriving over 5 years later and is able to eat solid foods again.

Cost of Treatment for Pleural Mesothelioma

The cost of treatment for pleural mesothelioma can be influenced by the type of treatment, stage of the disease, and health care provider.

Based on a report in Rare Tumors, it costs an average of $38,779 for six cycles of mesothelioma chemotherapy. The same report found that EPP surgery costs $62,408 on average. Additionally, the price of medications, inpatient procedures, and doctor’s visits can quickly add up.

Fortunately, financial assistance is available to help alleviate the burden on patients and their families.

Patients can manage their pleural mesothelioma treatment expenses through:

  • Legal settlements and verdicts: Lawsuits against manufacturers responsible for asbestos exposure can result in settlements averaging $1.1 million to $1.4 million.
  • Asbestos trust funds: Over $30 billion is available in asbestos trust funds set up by product manufacturers to compensate mesothelioma victims. Claims can start paying out within 90 days with an average of $41,000 per trust.
  • VA benefits: Veterans with mesothelioma may qualify for nearly $4,000 per month in disability compensation to help cover their medical expenses.

By exploring these avenues for financial support, patients can better manage the expenses associated with their pleural mesothelioma treatment and focus on their health and well-being.

Start Pleural Mesothelioma Treatment Today

Pleural mesothelioma is an aggressive cancer that requires an individualized treatment plan. With the right support, you or your loved one can live a longer, fuller life with fewer symptoms.

Our team of registered nurses and Patient Advocates can help you:

  • Find the right mesothelioma specialist and cancer center
  • Manage treatment-related side effects
  • Connect with other patients who are navigating treatment
  • Explore your options for financial compensation

Call (866) 608-8933 now or use our Free Doctor Match to start your pleural mesothelioma treatment journey.

Disclaimer

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.

Malignant Pleural Mesothelioma Treatment FAQs

What is the best treatment for pleural mesothelioma?

The most effective way to treat pleural mesothelioma is a combination of surgery, chemotherapy, radiation therapy, and/or immunotherapy. Doctors refer to this as multimodal therapy.

However, your individual treatment plan will vary based on the cancer’s location, its stage, your overall health, and any existing medical conditions.

A specialist can review these factors to recommend the most suitable treatment(s) for you, balancing potential risks, side effects, and benefits.

What is the newest treatment for pleural mesothelioma?

The newest treatment for pleural mesothelioma is a combination of the immunotherapy drugs Opdivo®️ (nivolumab) and Yervoy®️ (ipilimumab). This treatment is especially helpful for patients who can’t get surgery.

There’s also ongoing research on integrating different immunotherapy medications with chemotherapy and antiangiogenic drugs like lenvatinib (Lenvima®) and bevacizumab (Avastin®). These drugs are used to deprive cancer tumors of their blood supply, which can slow down or even shrink them in some cases.

What is the late-stage treatment for pleural mesothelioma?

Chemotherapy is the primary treatment for stage 4 pleural mesothelioma. However, new treatments in clinical trials offer hope for the management of malignant pleural mesothelioma in later stages.

Late-stage malignant pleural mesothelioma treatment can also include less-invasive surgeries and pain medications. These can all ease symptoms and improve the patient’s quality of life.

Can cancer in the pleura be cured?

There isn’t a cure for cancer in the lung lining (pleura) at this time, but it’s possible to become a mesothelioma survivor with treatment from a specialist.

Some patients have lived more than 10 years after their diagnosis.

What is the life expectancy of a person with pleural mesothelioma?

The average life expectancy for a person diagnosed with pleural mesothelioma ranges from 12 to 21 months.

Patients with epithelioid mesothelioma, the most common malignant mesothelioma cell type, have the best outlook (prognosis). This cell type spreads slower and remains relatively isolated in the body, compared to the sarcomatoid or biphasic cell types.

Other factors include the tumor’s location, the patient’s age, and their overall health.

Jenna TozziWritten by:

Director of Patient Advocacy

Jenna Tozzi, RN, is the Director of Patient Advocacy at Mesothelioma Hope. With more than 15 years of experience as an adult and pediatric oncology nurse navigator, Jenna provides exceptional guidance and support to mesothelioma patients and their loved ones. Jenna has been featured in Oncology Nursing News and is a member of the Academy of Oncology Nurse & Patient Navigators & the American Nurses Association.

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References
  1. Aprile, V., et al. (2021). Hyperthermic Intrathoracic Chemotherapy for Malignant Pleural Mesothelioma: The Forefront of Surgery-Based Multimodality Treatment. Journal of clinical medicine, 10(17), 3801. Retrieved February 14, 2024, from https://doi.org/10.3390/jcm10173801
  2. Baas, Paul et al. Lancet. (January 2021). First-line nivolumab plus ipilimumab in unresectable malignant pleural mesothelioma (CheckMate 743): a multicentre, randomised, open-label, phase 3 trial. Retrieved February 14, 2024, from https://pubmed.ncbi.nlm.nih.gov/33485464/
  3. Berzenji, L., & Van Schil, P. (2018). Multimodality treatment of malignant pleural mesothelioma. F1000Research, 7, F1000 Faculty Rev-1681. Retrieved February 14, 2024, from https://doi.org/10.12688/f1000research.15796.1
  4. Borrelli, E., Babcock, Z., & Kogut, S. (2019). Costs of medical care for mesothelioma. Rare tumors, 11, 2036361319863498. Retrieved February 14, 2024, from https://doi.org/10.1177/2036361319863498
  5. Breda, C., et al. (2021). Long-term outcomes after lung-sparing surgery for epithelial mesothelioma. Journal of thoracic disease, 13(11), 6283–6293. Retrieved February 14, 2024, from https://doi.org/10.21037/jtd-21-691
  6. Cavin, S., et al. (2020). Low-dose photodynamic therapy promotes a cytotoxic immunological response in a murine model of pleural mesothelioma. European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery, 58(4), 783–791. Retrieved February 14, 2024, from https://pubmed.ncbi.nlm.nih.gov/32372095/
  7. Cedres, S., et al. (2023). Current State-of-the-Art Therapy for Malignant Pleural Mesothelioma and Future Options Centered on Immunotherapy. Cancers, 15(24), 5787. Retrieved February 14, 2024, from https://doi.org/10.3390/cancers15245787
  8. Ceresoli, G. L., et al. (2019). Tumour Treating Fields in combination with pemetrexed and cisplatin or carboplatin as first-line treatment for unresectable malignant pleural mesothelioma (STELLAR): a multicentre, single-arm phase 2 trial. The Lancet. Oncology, 20(12), 1702–1709.  Retrieved February 14, 2024, from https://pubmed.ncbi.nlm.nih.gov/31628016/
  9. Forde, P. M., et al. (2021). Durvalumab with platinum-pemetrexed for unresectable pleural mesothelioma: survival, genomic and immunologic analyses from the phase 2 PrE0505 trial. Nature medicine, 27(11), 1910–1920. Retrieved February 14, 2024, from https://doi.org/10.1038/s41591-021-01541-0
  10. Journal of Clinical Oncology. (April 2023). Stinchcombe, MD, Thomas. Flashback Foreword: Pemetrexed and Cisplatin in Mesothelioma. Retrieved February 14, 2024, from https://ascopubs.org/doi/abs/10.1200/JCO.22.02720
  11. Klotz, L. V., et al. (2022). Multimodal therapy of epithelioid pleural mesothelioma: improved survival by changing the surgical treatment approach. Translational lung cancer research, 11(11), 2230–2242. Retrieved February 14, 2024, from https://doi.org/10.21037/tlcr-22-199
  12. National Cancer Institute. (n.d.). Side Effects of Cancer Treatment. Retrieved February 14, 2024, from https://www.cancer.gov/about-cancer/treatment/side-effects
  13. National Cancer Institute. (2023, June 8). Cisplatin. Retrieved February 14, 2024, from https://www.cancer.gov/about-cancer/treatment/drugs/cisplatin
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