Key Facts About Mesothelioma Treatment
Primary mesothelioma treatments

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

  • Surgery icon
    Surgery
    Patients 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.
  • Chemo icon
    Chemotherapy
    Doctors 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.
  • Radiation therapy icon
    Radiation
    Radiation 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.
  • Multimodal therapy icon
    Multimodal Therapy
    Multimodality treatment combines two or more mesothelioma therapies. The combined approach controls cancer growth better than using only one treatment.
  • Ttfields icon
    Tumor Treating Fields
    Tumor 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.
  • Immunotherapy icon
    Immunotherapy
    Immunotherapy 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.
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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.

Types of Mesothelioma

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

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

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

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

Peritoneal mesothelioma accounts for around 20% of cases and grows in the peritoneum, which lines the abdominal cavity. Surgery with heated chemotherapy is typically the most effective treatment for this variant.

Surgery

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

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

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

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

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

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

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.

  • Thoracentesis
    Doctors use a long needle inserted into the pleura to remove fluid buildup around the lungs.
  • PleurX Catheter
    Surgeons place this small drain in the chest to prevent fluid buildup around the lungs.
  • Pleurodesis
    This surgery eliminates the space in the pleura, where fluid can develop. It can be more invasive than other options.
  • Radiation
    Radiotherapy can shrink tumors to reduce chest pain and other cancer symptoms.
  • Paracentesis
    A long needle inserted in the abdomen removes fluid buildup called ascites. This reduces abdominal pressure in peritoneal cancer.
  • Pericardiocentesis
    This 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 Fontaine
Thoracic 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.

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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.

Important Self Care Tips to Consider

Diet & Nutrition

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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

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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

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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.

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“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 Parekh
Registered & 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.

  • TENS Therapy
    Small at-home device uses electrical stimulation over the skin to relieve muscle pains.
  • Accupuncture & Massage
    Thin needles stimulate nerves and muscles to relieve pain. Therapeutic massage can lower fatigue and anxiety.
  • Medical Marijuana
    CBD and THC options may reduce certain chemotherapy side effects. They can improve nausea and vomiting, loss of appetite, pain and insomnia.
  • Herbal Medicine
    Botanical products may ease symptoms related to treatment or cancer. They may also improve immunity.
  • Energy Therapies
    Music therapy, therapeutic touch or reiki may provide soothing feelings or stress relief. Energy therapies are not effective as a cancer treatment.
  • Mind-Body Therapies
    Hypnosis 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.

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Find a Specialist Near You

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Watch: Dr. Marcelo DaSilva discusses the importance of seeing a mesothelioma specialist

Top Mesothelioma Cancer Centers

Moffitt Cancer Center
12902 Magnolia Drive, Tampa, FL 33612
Doctors in Hospital: 10
Brigham and Women’s Hospital
75 Francis St, Boston, MA 02115
Doctors in Hospital: 5
MD Anderson Cancer Center
1515 Holcombe Blvd, Houston, TX 77030
Doctors in Hospital: 8
Mount Sinai Hospital
1 Gustave L. Levy Pl New York, NY 10029
Doctors in Hospital: 4
Lung Institute at Baylor College of Medicine
6620 Main St Suite 1325 Houston, TX 77030
Doctors in Hospital: 7
Rogel Cancer Center at University of Michigan
E Medical Center Drive, Ann Arbor, MI 48109
Doctors in Hospital: 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

  • Surgery
    $30,096
    A 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.
  • chemotherapy
    $9,600 per month
    A 2019 study compared lung cancer chemotherapy costs at various stages. The researchers showed that initial chemotherapy could cost up to $9,600 per month.
  • radiation
    $8,005
    A 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.

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Common Questions About Mesothelioma Treatment

What are the main types of treatment for mesothelioma?

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?

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?

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?

Yes, developing COVID-19 could delay cancer treatments. Patients must first recover from infection before their doctor can continue treating mesothelioma.