Mesothelioma Treatments

How is mesothelioma treated?

Depending on the type and stage, mesothelioma can be treated using surgery, chemotherapy, radiation therapy, or immunotherapy. Your care team may use a combination of these treatments, known as a multimodal approach.

Mesothelioma cancer treatments may include:

Surgery
Chemotherapy
Radiation therapy
Immunotherapy
Targeted therapies
Palliative treatments
Complementary therapies
Clinical trials

Surgery

Surgery is often one of the first steps in your care plan for mesothelioma. The type of surgery will depend on where your mesothelioma started and how far it has progressed.

Your healthcare provider will discuss the goals of your specific surgery. In most cases of mesothelioma, surgery is unable to remove all the cancer. Instead, the goal of surgery is to manage symptoms and improve your quality of life.

Cytoreductive Surgery with Heated Chemotherapy (HIPEC)

Cytoreductive Surgery with Heated Chemotherapy (HIPEC) is a surgical option that treats peritoneal mesothelioma, which starts in the lining of the abdomen. It combines surgery with chemotherapy.

First, your surgeon will remove cancer in the abdomen. Next, high doses of heated chemotherapy drugs are placed inside the abdomen to destroy any remaining cancer cells. These drugs are left for a short time and then removed.
Debulking surgery

Debulking surgery is a procedure that may treat pleural mesothelioma and peritoneal mesothelioma. It is less extensive than other surgical options. During the surgery, your care team removes as much of the cancer as possible.
Extrapleural Pneumonectomy (EPP)

Extrapleural pneumonectomy (EPP) is a surgical procedure used to treat pleural mesothelioma found in your lungs. It’s much more extensive than traditional pneumonectomy, which removes one lung, or other lung procedures for mesothelioma.

During EPP, your surgeon will remove the entire lung on one side of the chest, the lining around it, part of the diaphragm, nearby lymph nodes and sometimes the sac around the heart.
Omentectomy

If your abdominal mesothelioma has spread to the fatty tissue covering the organs in your abdomen (called the omentum), your doctor may suggest an omentectomy. This surgery removes the fatty tissue affected by cancer.
Pleurectomy and Decortication (P/D)

This surgical procedure is a treatment option that leaves the lung and diaphragm in place. During P/D, the surgeon removes the lining around the lung (the pleura) and any tumors or abnormal masses. In early mesothelioma, P/D may remove all the cancer, but it’s often used to relieve symptoms.

Mesothelioma chemotherapy

Chemotherapy uses drugs to destroy cancer cells in the body and is a standard part of treatment plans for mesothelioma. In the later stages of the disease, chemotherapy is often the primary treatment option to slow cancer growth.

In earlier stages of mesothelioma, your care team may recommend chemotherapy along with surgery. Before surgery, chemotherapy helps shrink the size of tumors. After surgery, it helps destroy cancer cells that couldn’t be seen or removed during your procedure. In some cases, your care team may use localized chemotherapy during surgery.

Hyperthermic intraperitoneal chemotherapy (HIPEC)

This type of local chemotherapy is given during a surgical procedure to treat peritoneal mesothelioma. After areas of cancer are surgically removed, your care team delivers a high dose of heated chemotherapy drugs directly into the abdomen.

Hyperthermic intrathoracic chemotherapy (HITHOC)

HITHOC is a type of localized chemotherapy treatment for pleural mesothelioma. Your care team delivers a high dose of heated chemotherapy drugs directly into the chest. As this type of chemo is more targeted to the specific area of cancer, it may have fewer side effects than chemotherapy infusions that affect the whole body.

Mesothelioma radiation therapy

Radiation therapy is a treatment for pleural mesothelioma that destroys cancer cells by using targeted beams or particles of radiation. Although it is not typically a treatment option for peritoneal mesothelioma, it can be used after surgery has removed a lung. In the later stages of mesothelioma, radiation therapy is usually a palliative treatment to manage symptoms or relieve pain.

Mesothelioma immunotherapy

Immunotherapy helps your immune system better recognize and fight cancer cells. It’s an approved treatment option for some people living with pleural mesothelioma who can’t be treated using surgery. Immunotherapy destroys cancer cells and often has fewer side effects than traditional chemotherapy drugs.

The main immunotherapy drugs for mesothelioma treatment are checkpoint inhibitors. This type of immunotherapy works by blocking certain checkpoints on cancer cells, allowing the body to recognize those cells as harmful and destroy them.

Targeted therapy for mesothelioma

Mesothelioma cancer cells have undergone abnormal changes. Targeted therapies identify these changes to specifically target the cells and slow the growth of cancer; they are often used together with chemotherapy.

The primary targeted therapy for mesothelioma is a drug called bevacizumab. It targets a protein in cancer cells that aids new blood vessel growth. Stopping new blood vessels from growing deprives or “starves” the cancer cells of nutrients, preventing them from spreading.

Palliative care

Palliative care focuses on reducing mesothelioma symptoms, improving quality of life and supporting patients throughout treatment. Treatments could include surgical procedures, medications, pain management, respiratory therapy, nutrition, emotional support, and spiritual care.

While hospice care is an option when other treatments have stopped, palliative care provides benefits at any stage of your mesothelioma treatment.

Palliative surgeries

It’s common for mesothelioma to cause fluid buildup. Palliative procedures or surgeries can reduce this buildup, providing relief from symptoms.

Pleurocentesis: Also called thoracentesis, pleurocentesis is a minimally invasive procedure that uses a hollow needle to remove fluid buildup, known as pleural effusion, from the space between the lining of the lungs and the chest wall. It can help relieve symptoms like shortness of breath.
Pleurodesis: Pleurodesis stops fluid buildup in the chest by closing off the space between the lining of the lungs and the lining of the chest wall. Preventing fluid buildup makes it easier for people with pleural mesothelioma to breathe.
Paracentesis: Paracentesis is a procedure to treat peritoneal mesothelioma. Your care team uses a needle to drain fluid buildup in the abdomen, relieving stomach pain and breathing problems.

Complementary therapies

Through our integrative medicine programs, you’ll have access to alternative or complementary therapies and traditional mesothelioma treatments. These therapies can help to reduce pain, relieve stress and manage symptoms during your care.

Some complementary therapies include:

Massage therapy
Acupuncture
Herbal medicine
Relaxation and breathing techniques
Medical nutrition therapy

Supportive care

Mesothelioma affects you and your family in many ways, not just physically but also emotionally, spiritually, socially and financially. Connecting with support services gives you the tools to navigate each step of your care confidently.