Malignant Mesothelioma Treatment Option Overview

There are different types of treatment for patients with malignant mesothelioma.

Different types of treatments are available for malignant mesothelioma. You and your cancer care team will work together to decide your treatment plan, which may include more than one type of treatment. Many factors will be considered, such as the stage of the cancer, your overall health, and your preferences. Your plan will include information about your cancer, the goals of treatment, your treatment options and the possible side effects, and the expected length of treatment. 

Talking with your cancer care team before treatment begins about what to expect will be helpful. You’ll want to learn what you need to do before treatment begins, how you’ll feel while going through it, and what kind of help you will need. To learn more, visit Questions to Ask Your Doctor About Treatment. 

The following types of treatment are used:

Surgery

The following surgical treatments may be used for malignant mesothelioma in the chest:

• Wide local excision is surgery to remove the cancer and some of the healthy tissue around it. The amount of healthy tissue removed depends on how deep or how large the tumor being removed is.
• Pleurectomy and decortication is surgery to remove part of the covering of the lungs and lining of the chest and part of the outside surface of the lungs.
• Extrapleural pneumonectomy is surgery to remove one whole lung and part of the lining of the chest, the diaphragm, and the lining of the sac around the heart.
• Pleurodesis is surgery that uses chemicals or drugs to make a scar in the space between the layers of the pleura. Fluid is first drained from the space using a catheter or chest tube and the chemical or drug is put into the space. The scarring stops the build-up of fluid in the pleural cavity.

After the doctor removes all the cancer that can be seen at the time of the surgery, some people may receive chemotherapy or radiation therapy to kill any cancer cells that are left. Treatment given after the surgery, to lower the risk that the cancer will come back, is called adjuvant therapy.

Radiation therapy

Radiation therapy uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. External radiation therapy uses a machine outside the body to send radiation toward the area of the body with cancer. It may also be used as palliative care to relieve symptoms and improve quality of life.

Chemotherapy

Chemotherapy (also called chemo) uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Combination chemotherapy is the use of more than one anticancer drug.

Systemic chemotherapy is when chemotherapy is taken by mouth or injected into a vein or muscle. When given this way, the drugs enter the bloodstream and can reach cancer cells throughout the body.

Regional chemotherapy is when chemotherapy is placed directly into an organ or a body cavity, such as the chest or peritoneum. When given this way, the drugs mainly affect cancer cells in those areas. Hyperthermic intraperitoneal chemotherapy (HIPEC) is a type of regional chemotherapy used to treat malignant mesothelioma:

• HIPEC may be used to treat mesothelioma that has spread to the peritoneum (tissue that lines the abdomen and covers most of the organs in the abdomen). After the surgeon removes all the cancer that can be seen, a solution containing anticancer drugs is heated and pumped into and out of the abdomen to kill cancer cells that remain. Heating the anticancer drugs may kill more cancer cells.

The way the chemotherapy is given depends on the type and stage of the cancer being treated.

Learn more about how chemotherapy works, how it is given, common side effects, and more at Chemotherapy to Treat Cancer and Chemotherapy and You: Support for People With Cancer.

Visit Drugs Approved for Malignant Mesothelioma for more information.

Immunotherapy

Immunotherapy helps a person's immune system fight cancer. Your doctor may suggest biomarker tests to help predict your response to certain immunotherapy drugs. Learn more about Biomarker Testing for Cancer Treatment.

Immunotherapy drugs used to treat advanced mesothelioma include:

Other immunotherapy drugs, such as , are being studied in malignant mesothelioma.

Learn more about Immunotherapy to Treat Cancer.

Targeted therapy

Targeted therapy uses drugs or other substances to identify and attack specific cancer cells. is a targeted therapy drug used to treat malignant mesothelioma.

Other targeted therapies, such as , are being studied in malignant mesothelioma.

Learn more about Targeted Therapy to Treat Cancer.

New types of treatment are being tested in clinical trials.

Joining a clinical trial may be an option. There are different types of clinical trials for people with mesothelioma. For example, a treatment trial tests new treatments or new ways of using existing treatments. Supportive care and palliative care trials look at ways to improve quality of life, especially for those who have side effects from cancer and its treatment.

You can use the clinical trial search to find NCI-supported cancer clinical trials that are accepting participants. This search allows you to filter trials based on the type of cancer, your age, and where the trials are being done. Clinical trials supported by other organizations can be found on the ClinicalTrials.gov website.

Learn more about clinical trials at Clinical Trials Information for Patients and Caregivers.

Treatment for malignant mesothelioma may cause side effects.

For information about side effects caused by treatment for cancer, visit our Side Effects page.

Follow-up care may be needed.

As you go through treatment, you will have follow-up tests or check-ups. Some tests that were done to diagnose or stage the cancer may be repeated to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests.

Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your condition has changed or if the cancer has recurred (come back).