
Mesothelioma Treatment
Treatment for malignant mesothelioma may include surgery, chemotherapy, radiation therapy, immunotherapy and targeted therapies. Mesothelioma patients may also access palliative care to relieve symptoms.
- Written by Dr. Daniel A. Landau
- Edited By Walter Pacheco
- Medically Reviewed By Dr. Jacques Fontaine
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APA
Landau, D. A. (2023, January 27). Mesothelioma Treatment. Asbestos.com. Retrieved January 31, 2023, from https://www.asbestos.com/treatment/
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Landau, Daniel A. "Mesothelioma Treatment." Asbestos.com, 27 Jan 2023, https://www.asbestos.com/treatment/.
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Landau, Daniel A. "Mesothelioma Treatment." Asbestos.com. Last modified January 27, 2023. https://www.asbestos.com/treatment/.
- Mesothelioma surgery offers the best chance of long-term survival.
- The most common treatment is chemotherapy, which extends survival and improves symptoms.
- Mesothelioma clinical trials test new and emerging treatments.
- The U.S. FDA approved a combination of two immunotherapy drugs for mesothelioma in 2020.
- Doctors specializing in mesothelioma use the best therapies to help patients live longer.

How Is Mesothelioma Treated?
Mesothelioma is treated with surgery, chemotherapy, radiation and other conventional and emerging treatments. Current recommendations for treating mesothelioma come from The American Society of Clinical Oncology.
Traditional Treatments
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SurgeryPatients diagnosed in the early stages benefit most from mesothelioma surgery. It offers them the best chance at living longer lives. These procedures remove visible tumors from the chest area.
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ChemotherapyDoctors may recommend chemotherapy to mesothelioma patients deemed ineligible for surgery. Chemotherapy also helps extend survival rates. Researchers found chemo drug combinations can extend life expectancies.
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RadiationRadiation therapy controls symptoms when surgery is not an option. It eases symptoms such as chest pain and discomfort. Radiation can reduce the risk of local recurrence when combined with surgery.
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Multimodal TherapyMultimodality treatment combines two or more mesothelioma therapies. The combined approach controls cancer growth better than using only one treatment.
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Tumor Treating FieldsTumor Treating Fields uses electrical fields to disrupt cancer cells and limit growth. Adhesive pads attached to a portable battery device deliver this therapy for pleural mesothelioma.
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ImmunotherapyImmunotherapy drugs for mesothelioma help the immune system identify and kill cancer cells. Keytruda and Bevacizumab are immunotherapy drugs that use antibodies to limit tumor growth.

Treatments by Mesothelioma Type
Primary treatments for pleural and peritoneal mesothelioma include surgery, chemotherapy and radiation therapy. These treatments can relieve symptoms, improve prognosis and extend life expectancy.
The benefits and risks of each option depend on the cancer type and stage. For example, hyperthermic intrathoracic chemotherapy (HITHOC) for pleural mesothelioma remains experimental. Heated intraperitoneal chemotherapy (HIPEC) for peritoneal mesothelioma has proven very successful.
Pleural Mesothelioma Treatments
Pleural mesothelioma affects the pleura, the outer lining of the lungs. Almost 75% of mesothelioma cases are pleural. These treatments remove or shrink pleural tumors. They can reduce symptoms and improve quality of life.
- Surgery
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Extrapleural Pneumonectomy (EPP): EPP removes the cancerous lung and nearby areas. Surgeons may remove lymph nodes, chest and heart linings and diaphragm.
Pleurectomy Decortication (P/D): P/D spares the lung. This surgery removes tumors from the pleura, chest lining and diaphragm. P/D is less aggressive than EPP.
- Chemotherapy
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Combination Chemotherapy: Doctors often prescribe pemetrexed (Alimta) with cisplatin for mesothelioma. This first-line treatment with mesothelioma chemotherapy drugs is for first-time therapy. If cancer returns, second-line options may include gemcitabine (Gemzar) or carboplatin.
- Radiation
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External Beam Radiation Therapy: EBRT is the most common radiation treatment for mesothelioma. An external machine delivers X-ray beams to kill cells at the cancer site. Doctors may use EBRT before or during surgery.
Brachytherapy: This internal radiation therapy uses an implant to kill nearby cancer cells. Like EBRT, doctors may combine brachytherapy with other conventional treatments.
Peritoneal Mesothelioma Treatments
- Surgery
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Cytoreductive Surgery: The goal of cytoreductive surgery is to eliminate cancerous growths. Portions of affected organs, such as the stomach, liver, intestines and others, are removed. When surgeons remove cancerous parts of the peritoneum, the procedure is called a peritonectomy. When treating mesothelioma, doctors often combine surgery with heated chemotherapy.
- Chemotherapy
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Heated Intraperitoneal Chemotherapy (HIPEC): HIPEC is the most effective mesothelioma treatment option for the peritoneal type based on a 2022 study. Using a special pump and infusion machine, doctors deliver heated chemotherapy drugs to wash the abdominal cavity after surgery. The HIPEC process helps kill the remaining cancer cells left behind after surgery.
Pericardial Mesothelioma Treatments
Pericardial mesothelioma is a rare variant of the disease, present in only 1% of all known cases. This cancer grows along the lining of the heart sac known as the pericardium. Treatment options are limited because many therapies can also damage the nearby heart.
- Surgery
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Pericardiectomy: About half of pericardial patients are eligible for this surgery, removing part or all of the pericardium. A pericardiectomy can reduce fluid buildup and prevent excess pressure on the heart, which can impair function.
- Chemotherapy
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Pemetrexed and Cisplatin: The traditional chemotherapy regimen for pleural mesothelioma has shown some benefits for pericardial patients, helping to extend life expectancy. In some trials, gemcitabine and pembrolizumab, a new immunotherapy drug, have also proven advantageous.
Testicular Mesothelioma Treatments
Testicular mesothelioma is an aggressive form of cancer and can spread rapidly. The variant accounts for less than 1% of all cases and may develop as a secondary tumor from peritoneal mesothelioma. Nearly half of patients with this type live for five years or more with treatment.
- Surgery
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Orchiectomy: The surgical option available for over 98% of testicular mesothelioma patients is an orchiectomy. In this procedure, the surgeon removes the cancerous testicle and the spermatic cord.
- Chemotherapy
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Pemetrexed and Cisplatin: The standard chemotherapy regimen of pemetrexed and cisplatin for mesothelioma often follows surgery to help kill any remaining cancerous cells. Chemotherapy after surgery has proven to improve mesothelioma prognosis.
- Radiation
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A small percentage of testicular mesothelioma patients, about 5%, receive radiation therapy after surgery. Researchers are still determining the benefits of this treatment, but radiation could help prevent testicular mesothelioma recurrence after surgery.
Palliative Care for Mesothelioma
Mesothelioma palliative treatment focuses on controlling symptoms. It can improve the quality of life and relieve symptoms as a supportive care option.
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ThoracentesisDoctors use a long needle inserted into the pleura to remove fluid buildup around the lungs.
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PleurX CatheterSurgeons place this small drain in the chest to prevent fluid buildup around the lungs.
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PleurodesisThis surgery eliminates the space in the pleura, where fluid can develop. It can be more invasive than other options.
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RadiationRadiotherapy can shrink tumors to reduce chest pain and other cancer symptoms.
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ParacentesisA long needle inserted in the abdomen removes fluid buildup called ascites. This reduces abdominal pressure in peritoneal cancer.
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PericardiocentesisThis procedure removes fluid and pressure from the sac surrounding the heart.
“Supportive care medicine is a new specialized branch of medicine that reduces pain, increases appetite and boosts morale. Every mesothelioma patient should ask to be seen by this type of medical specialist, in addition to a thoracic surgeon and medical oncologist.”Dr. Jacques FontaineThoracic Surgeon for Mesothelioma
Clinical Trials and Emerging Treatments
Mesothelioma doctors test the safety and efficacy of new therapies in clinical trials.
The goal of clinical trials is to find a mesothelioma cure or improve life expectancy. At some point, these experimental therapies could become conventional options.

Emerging Treatments for Mesothelioma
- Cryotherapy
Cryotherapy is a non-invasive surgical procedure that freezes cancer cells to kill them. The procedure can shrink tumors before surgery. After surgery, it can treat recurrences or control symptoms as a palliative option.
- Gene Therapy
Modifying the DNA of cells and viruses can help control cancer. One method repairs the p53 gene to kill cancer cells before they multiply.
- Photodynamic Therapy
Doctors use laser light energy to activate a unique drug and kill cancer cells.
- Virotherapy
Virotherapy is a cancer treatment that uses viruses to find and attack cancer cells. Some methods involve gene therapy or immunotherapy to make the treatment more effective.
Clinical Trials Success Stories
Clinical research studies offer, at least, the current standard of care. Patients may also receive promising new therapies that could extend survival.
Nutrition & Self-Care During Mesothelioma Treatment
A healthy diet and mindful self-care routines are essential. They can reduce side effects, improve mesothelioma prognosis and extend survival. These techniques round out a complete mesothelioma treatment plan.
Diet & Nutrition

Nutrition guidelines from a dietitian can improve well-being and recovery time.
Patients should try to keep a balanced diet to maintain weight and energy. Maintaining an appropriate weight before surgery can reduce the risk of infection.
Diets rich in protein and calories can benefit every cancer patient. Benefits apply before, during and after treatment.
Protein allows muscles to heal faster from damage during surgery. More calories give your body energy to repair cells and tissues after treatment.
Some mesothelioma treatments can make eating more difficult. Several techniques, including certain foods and meals, can manage these challenges. Patients considering over-the-counter vitamins or supplements should always talk with their doctor first.
Exercise & Fitness

Regular exercise improves strength and can speed recovery after treatment. Cancer doctors may suggest exercises to reduce fatigue, increase appetite and improve mood.
Examples of safe and effective low-impact exercises include:
- Yoga
- Walking
- Swimming
- Cycling
- Lightweight strength training
- Stair climbs
Pleural mesothelioma patients should take precautions when undertaking any exercise. For example, cardiovascular and upper body workouts can impact breathing.
People undergoing surgery or chemotherapy should ask their doctor about resuming exercise. Safe workouts can include gentle activities without worsening fatigue.
Mental Health

Mesothelioma cancer can be a significant burden on mental health. Patients undergoing active treatment often struggle with negative thoughts, depression and anxiety. A strong focus on self-care and mental health awareness can improve your quality of life.
Mesothelioma patients have several options for improving their mental health, including:
- Mesothelioma support groups
- Mental health counselors
- Physical therapy and exercise
- A healthy, well-balanced diet
- Palliative care and pain management
Mental health resources are available from doctors, nurses and caregivers. Health care teams are familiar with the emotional drain of a mesothelioma diagnosis. Professional psychological care can improve sleep and limit feelings of anxiety and depression.

“Cancer and nutrition is such a growing area, and research is underway daily to find out how we can better protect ourselves from this disease.”Tejal ParekhRegistered & Licensed Dietitian
Complementary & Alternative Medicine
Complementary therapies, alongside traditional medicine, can provide benefits for some patients. They may reduce pain or improve well-being. Patients should consult their doctor before using any supplement or alternative medicine.
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TENS TherapySmall at-home device uses electrical stimulation over the skin to relieve muscle pains.
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Accupuncture & MassageThin needles stimulate nerves and muscles to relieve pain. Therapeutic massage can lower fatigue and anxiety.
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Medical MarijuanaCBD and THC options may reduce certain chemotherapy side effects. They can improve nausea and vomiting, loss of appetite, pain and insomnia.
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Herbal MedicineBotanical products may ease symptoms related to treatment or cancer. They may also improve immunity.
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Energy TherapiesMusic therapy, therapeutic touch or reiki may provide soothing feelings or stress relief. Energy therapies are not effective as a cancer treatment.
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Mind-Body TherapiesHypnosis and biofeedback are mind-body therapies that may reduce pain and discomfort. They involve thought exercises and whole-body mindfulness.
Top Mesothelioma Doctors and Cancer Centers
Mesothelioma specialists can offer the latest treatment options not provided by general oncologists. Top mesothelioma cancer centers are home to the newest technology and methods. These therapies can extend life expectancy, improve prognosis and restore well-being.
Top Mesothelioma Cancer Centers
- Year Built: 1986
- Number of Beds: 206 beds
- Number of Physicians: 10
- Year Built: 1832
- Number of Beds: 793 beds
- Number of Physicians: 5
- Year Built: 1941
- Number of Beds: 546 beds; 105,000 patient visits in 2010
- Number of Physicians: 8
- Year Built: 1855
- Number of Beds: 1,144 beds
- Number of Physicians: 4
- Year Built: 1969
- Number of Physicians: 7
- Year Built: 1986
- Number of Beds: 3,894 cancer patients admitted in 2010
- Number of Physicians: 2
How Much Does Treatment Cost?
The average cost for treating malignant pleural mesothelioma is comparable to lung cancer. The National Cancer Institute shows treatments for lung cancer can cost $73,225 in the first year. Every situation is unique, and therapy expenses vary. Early financial planning can make payment more manageable and reduce stress.
Average Mesothelioma Treatment Cost by Type of Therapy
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Surgery$30,096A 2017 Harvard Medical School study reported that a lung cancer patient could pay an average of $30,096 for the initial surgery and $4,263 in monthly costs.
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chemotherapy$9,600 per monthA 2019 study compared lung cancer chemotherapy costs at various stages. The researchers showed that initial chemotherapy could cost up to $9,600 per month.
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radiation$8,005A 2019 National Institute of Health study reported the median cost of initial radiation for lung cancer was $8,005. Repeat radiation can cost about $4,500.
How to Pay for Mesothelioma Treatment
Paying for mesothelioma treatment is a challenge for many patients and their loved ones. Health care expenses can accumulate from out-of-pocket fees, caregiving, symptom management and lost wages due to missed work.
Although many Americans rely on private health insurance to pay for the treatment of severe illnesses, other opportunities such as federal programs and legal options may cover the cost of cancer treatment.
Resources to Help Pay for Treatment
- Government Programs
Government assistance includes Social Security Disability Insurance, Supplemental Security Income and VA services.
- Charity Resources
Hospitals, non-profit groups and social workers can help you find financial resources such as free travel and lodging.
- Clinical Trials
Patients in clinical trials pay for standard treatment. The trial sponsor pays for the experimental treatments.
- Filing a Legal Claim
Patients and loved ones can file a legal claim for compensation. The reward helps cover medical bills, lost wages and other expenses.

Common Questions About Mesothelioma Treatment
- What are the main types of treatment for mesothelioma?
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Mesothelioma treatment includes chemotherapy, surgery and radiation therapy. Multimodal therapy combines two or more of these treatments. Emerging treatments, such as immunotherapy and gene therapy, are available through clinical trials.
- Are there any new treatment types that have shown to be effective for mesothelioma?
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Yes. The FDA approved Opdivo and Yervoy immunotherapy in October 2020. They also approved Tumor Treating Fields for pleural mesothelioma in May 2019. The average survival time is around one year for mesothelioma with chemotherapy. Adding new treatments can extend average survival by several months.
- Are there doctors who specialize in mesothelioma?
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Specialized oncologists, surgeons and other types of doctors have extensive experience treating mesothelioma. These doctors can confirm a mesothelioma diagnosis and develop an effective treatment plan.
- Will a COVID-19 diagnosis affect my mesothelioma treatment?
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Yes, developing COVID-19 could delay cancer treatments. Patients must first recover from infection before their doctor can continue treating mesothelioma.