Mesothelioma Treatment

While there is no cure for mesothelioma, there are many treatment options available that can extend a patient’s lifespan or make living with their illness easier. The most commonly used treatments for mesothelioma are surgery, chemotherapy, and radiation. However, clinical trials may give patients access to new treatment options. Patients should work with doctors who are mesothelioma specialists to determine what treatments may be best for them.

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What Are My Mesothelioma Treatment Options?

Options for mesothelioma treatment fall into two broad categories: curative and palliative.

Curative treatments are aimed at extending a patient’s lifespan or obtain a remission, while palliative treatments exist to reduce pain and discomfort. Regardless of whether a treatment is curative or palliative, doctors usually use the same three basic procedures to achieve the most effective results.

The primary treatments for mesothelioma are:

Doctors usually use more than one of these treatments to achieve the best health results. New treatment options are regularly tested in clinical trials and may be available to patients depending on their case.

There is no known cure for the majority of cases of mesothelioma, but patients who undergo a specialized treatment plan after diagnosis have a much higher chance of living longer.

Quick Facts About Mesothelioma Treatment

  • On average, aggressive surgeries improve a patient’s life expectancy by one year and, in many cases, have extended life by 5 years or more.
  • According to the Mayo Clinic, most mesothelioma patients are diagnosed too late to undergo life-extending surgery.
  • At least 80% of mesothelioma patients receive chemotherapy as their primary treatment option, according to the University of Chicago’s Cancer Research Center.
  • The total cost of mesothelioma treatment can reach over $500,000.

Mesothelioma Treatment Types

Standard treatment for mesothelioma takes the form of surgery, chemotherapy, and/or radiation.

While surgery is usually part of life-extending treatment plans, not all patients are good candidates for these aggressive procedures.

For example, some patients may have extensive cancer or a disease that has spread, be unable to tolerate surgery, or have cancers that cannot be removed. Such individuals may be given chemotherapy or radiation to try and shrink tumors and slow their growth.

The different treatment types are most effective when at least two of them are used together.

Surgery

The single most effective way to control the growth of mesothelioma and extend a patient’s life is through mesothelioma surgery.

According to Surveillance, Epidemiology, and End Results (SEER) program data collected by the National Cancer Institute (NCI), the median survival time for pleural mesothelioma patients with an epithelial cancer cell type increased with surgery.

Those who underwent surgery survived for 19 months after diagnosis. By comparison, the median survival of patients who did not receive treatment was 12 months.

Doctors have developed surgical procedures for different types of mesothelioma. Which surgery (if any) a doctor recommends depends on what type of mesothelioma a patient has and how far it has spread.

Most Common Mesothelioma Surgeries

Mesothelioma Type

Surgery

Description

Pleural Extrapleural pneumonectomy (EPP) Removal of the diseased lung and pleura
Pleural Pleurectomy with decortication (P/D) Removal of the diseased pleura and any visible tumors
Peritoneal Cytoreduction with hyperthermic intraperitoneal chemotherapy (HIPEC) Removal of all visible cancer in the abdomen followed by the direct application of chemotherapy drugs into the abdomen
Pericardial Pericardiectomy The removal of tumors by removing part or all of the lining of the heart

During surgery, doctors cut open the chest or abdomen and physically remove all visible tumor masses. In some cases, they also remove surrounding tissues or organs. In most cases, surgery is only used if a patient is strong enough to fully recover.

Doctors rarely treat mesothelioma with surgery alone, even when surgery is possible. Chemotherapy and/or radiation play a key role in destroying as much of the cancer as possible.

Chemotherapy

During mesothelioma chemotherapy, doctors circulate specialized drugs through a patient’s body to kill cancer cells. Chemotherapy is a common treatment for mesothelioma — by itself and combined with surgery.

Chemotherapy for mesothelioma may be used to:

  • Kill remaining cancer cells after surgery
  • Reduce tumor size
  • Slow the spread of mesothelioma
  • Treat patients who cannot have surgery

Doctors usually recommend multiple rounds of chemotherapy to kill as many cancer cells as possible. According to the American Cancer Society (ACS), mesothelioma patients are usually given a combination of the drugs cisplatin and pemetrexed.

Depending on the treatment approach, chemotherapy may be given before, during, or after surgery to increase the chances of long-term remission. However, patients may experience negative side effects from chemotherapy drugs, such as fatigue, hair loss, and nausea.

Radiation Therapy

Using powerful electromagnetic waves, radiation therapy for mesothelioma scrambles the DNA of mesothelioma cells, killing them.

Radiation therapy for mesothelioma may be used to:

  • Kill remaining cells at the tumor site after surgery
  • Shrink tumors to make surgery easier
  • Prevent mesothelioma cells from being spread around the body during surgery

Radiation is usually used alongside other forms of mesothelioma treatment.

Targeted Therapy

Targeted therapy is a new type of therapy that treats cancer with drugs designed to zero in on cancer cells, stopping them from reproducing or signaling them to destroy themselves while leaving normal cells alone.

Targeted therapy is different from traditional chemotherapy in two main ways:

  1. Targeted therapy leaves most healthy cells untouched, only affecting cancer cells. Traditional chemotherapy damages some healthy cells as well, causing negative side effects. Targeted therapy typically has fewer and different side effects than chemotherapy.
  2. Targeted therapy often works by stopping cancer cells from reproducing or making them change. Traditional chemotherapy aims to destroy cancer cells.

As researchers learn more about mesothelioma and the particular traits of its cancer cells, targeted drugs should become increasingly effective at stopping the disease in its tracks without harming patients.

According to the NCI, certain mesothelioma patients may now receive targeted therapy as part of their treatment plan. However, they will likely need other treatments such as traditional chemotherapy as well.

In addition, several targeted therapy drugs are being tested for mesothelioma, which patients may access in clinical trials.

Multimodality Therapy

While surgery, chemotherapy, and radiation are key mesothelioma treatments, they are most effective when used alongside one another. When two or more mesothelioma treatments are used together, it is known as multimodality therapy.

In most multimodal therapy plans, different forms of treatment are administered one after the other. For example, a patient may undergo surgery to remove visible cancer tumors and then undergo chemotherapy to kill microscopic cancer cells.

Doctors may apply several multimodal treatments in the process of surgery:

  • Before surgery: Patients may undergo neoadjuvant (pre-surgery) chemotherapy — a process used to kill mesothelioma cells and shrink tumors, improving the effectiveness of the surgery.
  • During surgery: Patients may also receive an injection of heated chemotherapy directly into the abdominal or chest cavity through a catheter immediately after surgery.
  • After surgery: Doctors may give intensity-modulated radiation therapy (IMRT) or other focused radiation treatments, which involve computerized radiation that send pre-measured doses directly to the tumor site to kill off remaining mesothelioma cells.

Different treatment combinations may be used depending on the type of mesothelioma and the patient’s overall health.

Pleural Mesothelioma Treatment

There are two standard pleural mesothelioma surgeries that doctors may use to help improve a patient’s lifespan.

Surgery options for pleural mesothelioma are:

Both procedures are multimodal approaches, involving surgery, chemotherapy, and sometimes radiation. However, their effectiveness at removing mesothelioma and the stress they place on a patient’s body may vary.

A mesothelioma doctor may recommend one treatment over the other depending on the patient, but it is up to the patient to decide which approach they take.

Extrapleural Pneumonectomy

EPP involves removing the diseased lung and the entire pleura (lung lining), as well as a portion of the diaphragm. It is considered a more aggressive surgery, but it may remove more of the mesothelioma tumor than P/D.

A study of 183 pleural mesothelioma patients, published in the Journal of Thoracic and Cardiovascular Surgery, found that, after being treated with EPP, the median survival time of patients was 19 months.

Surgeries like EPP are only given to patients who are healthy enough to withstand and recover from them. Multimodal treatment with EPP is an approach that can significantly improve a patient’s life expectancy.

Most studies show that patients can survive up to 2 years with this procedure, while some studies have shown the survival of nearly 4 years.

Pleurectomy With Decortication

P/D is a lung-sparing surgery in which doctors only remove the diseased pleura (lung lining) and in some cases, some lung tissue.

Like EPP, P/D is a multimodal therapy, with patients often receiving chemotherapy and/or radiation to help eliminate as much of the tumor as possible and slow growth.

The median life expectancy of patients who receive P/D is around 29 months. Some studies have shown a high 5-year survival rate in stage 1 pleural mesothelioma patients.

P/D has also been shown to have a lower short-term post-surgery mortality rate. Fewer patients develop fatal complications during or within 30 days after surgery compared to patients who undergo EPP.

Peritoneal Mesothelioma Treatment

Specialists consider peritoneal mesothelioma the easiest type to treat. During treatment, doctors will remove visible tumors and drain fluid buildup from the abdomen to help control the spread of disease.

Treatment for peritoneal mesothelioma focuses on:

  • Surgically removing visible tumors
  • Slowing the spread of remaining mesothelioma cells after surgery
  • Draining fluid buildup from the abdomen

The primary surgical procedure for treating peritoneal mesothelioma is called cytoreductive surgery (or cytoreduction) with HIPEC.

For the right candidate, cytoreduction with HIPEC is a lifesaving procedure that can lead to several months or even years with no detectable signs of cancer.

Cytoreductive Surgery

Cytoreductive surgery is the surgical removal of any visible tumor. It was developed by Dr. Paul Sugarbaker with the goal of removing all visible signs of mesothelioma.

Did You Know?

Several studies, including one by the NCI, have shown that the median life expectancy of patients after receiving cytoreduction with HIPEC is up to 7 years, though many patients have survived much longer.

By removing as much malignant (cancerous) tissue as possible, doctors control and potentially stop the spread of the tumors from the abdominal cavity to the rest of the body. During cytoreduction, surgeons remove the entire diseased peritoneum (abdominal lining) and any tumors or diseased tissue surrounding the abdominal cavity.

Heated Intraperitoneal Chemotherapy (HIPEC)

While the patient is undergoing cytoreductive surgery, the doctor may administer chemotherapy directly into the abdominal cavity.

The chemotherapy drugs are first heated and then allowed to circulate throughout the abdomen for up to 90 minutes to kill off any remaining, invisible mesothelioma cells.

Peritoneal mesothelioma patients generally receive radiation after surgery.

A combination of chemotherapy drugs administered after cytoreductive surgery helps prevent mesothelioma cell regrowth and stop the growth of certain proteins that promote tumor development.

Pericardial Mesothelioma Treatment

Because the disease is so rare and develops so close to the delicate heart, options for pericardial mesothelioma treatment are often limited.

Treatment for pericardial mesothelioma includes:

  • Chemotherapy
  • Palliative treatments
  • Tumor resection (tumor removal without removing the heart lining)
  • Pericardiectomy (removal of the heart lining)

When possible, doctors attempt a multimodal treatment approach consisting of surgery, chemotherapy, radiation, and/or immunotherapy.

Mesothelioma Treatment Goals

Mesothelioma treatments often work together to accomplish the overall goal of increasing a patient’s lifespan or quality of life.

The same treatment may be used differently depending on the patient and their treatment plan. For example, one patient may receive chemotherapy to kill remaining cancer cells after surgery while another may receive chemotherapy in hopes of shrinking a tumor and allowing the patient to breathe more easily.

Possible mesothelioma treatment goals include:

  • Drain fluid buildup in the space between the lung and the lung lining to increase comfort and quality of life
  • Kill mesothelioma cells
  • Manage pain and symptoms
  • Remove as much of the tumor as possible through surgery
  • Shrink tumors in size
  • Stop the mesothelioma from spreading to distant sites

Doctors should always explain the purpose of a particular treatment to patients and how it impacts the patient’s overall treatment goal.

Factors Affecting Mesothelioma Treatment

Before doctors recommend treatments, they consider multiple factors in each patient case.

These factors include:

  • Mesothelioma cell type
  • Overall patient health
  • Stage of the cancer when the patient was diagnosed
  • The rate at which the cancer is spreading
  • The location of the tumors and whether they encase other organs
  • The patient’s personal wishes

These factors not only influence a patient’s prognosis but also what they can expect their treatment regimen to look like.

Mesothelioma Treatment Timeline

The specific steps and timeline for mesothelioma treatment can look very different from patient to patient, but most treatment timelines will follow the same basic steps from diagnostic testing to final treatment.

Examining Symptoms

The first step on the way to treatment usually begins when a patient comes to their doctor complaining of symptoms such as a chronic cough, shortness of breath, night sweats, and general unwellness.

If a patient’s doctor is aware of a history of asbestos exposure, they may be more likely to suspect mesothelioma and begin testing early, starting with a physical exam.

A doctor may also order imaging tests such as an X-ray or computed tomography (CT) scan of the area where the patient is experiencing symptoms.

Scans may reveal tumors or other signs of mesothelioma such as fluid buildup in the tissues that line the organs. This will prompt further testing.

Doctors cannot diagnose mesothelioma solely with imaging tests, but they are an important early step toward diagnosis.

Getting a Diagnosis

Doctors need to perform a biopsy in order to make a mesothelioma diagnosis. During a biopsy, doctors remove tissue or fluid from an area where they suspect a cancerous tumor may be.

A tissue sample may be removed with:

  • Surgery: A surgical biopsy is the most extreme way to collect tissue, but doctors can collect the largest sample with this option.
  • Needle biopsy: During a needle biopsy, a needle is inserted into the area suspected to be cancerous, removing a thin sample of tissue.
  • Endoscopic biopsy: A thin, tube-like camera is inserted into the patient through a small incision (cut) to examine the tissue and collect a sample.

After collecting the sample, specialists will examine it, looking for cancerous mesothelioma cells.

Getting a Second Opinion

Mesothelioma is a rare disease that many doctors have little to no experience with. It is also very difficult to accurately diagnose, often leading to misdiagnosis.

For this reason, patients should seek a second opinion from a mesothelioma specialist.

Second opinions may help patients:

  • Discover top mesothelioma experts
  • Feel secure about their treatment plan
  • Lower the risk of misdiagnosis
  • Survive longer
  • Understand their mesothelioma better

Patients and their families may have to travel to get treatment at a top mesothelioma cancer center. A list of NCI-designated cancer centers may be found on the institute’s official website at cancer.gov.

Following a Treatment Plan

Once a patient has found a specialist, their mesothelioma care team will build a treatment plan tailored to their specific condition and personal wishes.

Most patients will receive multimodal treatment involving a combination of surgery, chemotherapy, radiation, and/or other methods.

While these treatments are designed to maximize a patient’s lifespan and comfort, they can be extremely expensive — easily more than $500,000 for total treatment costs.

This figure does not include related costs, such as travel and lodging while a patient gets treated at a top mesothelioma center, lost wages, and assisted living costs.

Second-Line Treatment for Mesothelioma

A patient receives second-line treatment after their first-line treatment (the treatment determined to be the most effective) fails to get results or stops working.

Unfortunately, nearly all mesothelioma patients eventually see their cancer continue to spread even if first-line treatment removes much of the tumor. At this point, doctors turn to second-line therapies.

Common second-line mesothelioma treatments include:

  • Chemotherapy
  • Additional surgery
  • Radiation therapy
  • Experimental therapies

In some cases, second-line treatment may further extend a patient’s life, but these treatments are often palliative, treating painful symptoms as a patient’s tumors continue to grow.

Clinical Trials

The latest developments in the treatment of mesothelioma often come from clinical trials taking place at top mesothelioma cancer centers.

During clinical trials, doctors test new therapies with the hopes of curing mesothelioma. Treatments that do not cure the disease may still extend patient lifespans or ease suffering.

Clinical trials have several benefits:

  • Access to new treatments: Many patients who did not respond well to standard treatments or have stopped seeing results have undergone treatments in clinical trials and extended their lives by several months. Patients whose mesothelioma has returned may also benefit from experimental treatments.
  • Helping others: Testing new treatments in clinical trials is essential for the mesothelioma research community and its goal of finding a cure for this terrible disease. It gives many patients satisfaction to know that their participation in a clinical trial may one day spare someone else from immense suffering.
  • More treatment information: Participating in a clinical trial may give patients increased access to information about other trials, support groups, and additional resources that may help them during and after treatment.

Clinical trials take place in a controlled environment that allows researchers to evaluate the safety and effectiveness of treatments and treatment combinations. Because trials typically focus on a specific treatment, researchers will only accept patients that meet certain qualifications for that trial.

Mesothelioma patients can speak with their doctors to learn more about clinical trials and if they may be able to join one.

New Mesothelioma Treatment Options

There are several new mesothelioma treatments currently being researched or actively tested in clinical trials. Some of the most promising and well-studied treatment options manipulate cell DNA to fight cancer.

With help from their doctors, patients that do not respond well to standard treatments may be able to receive new therapies.

Immunotherapy

Immunotherapy (also called biologic therapy) is a new treatment approach that transforms a patient’s immune system into a more effective cancer killer. The immune system is boosted using substances created in a lab or taken from a patient’s body.

Immunotherapy may work by:

  • Stopping or slowing cancer cell growth
  • Stopping cancer from spreading
  • Improving the immune system’s ability to destroy cancer cells

Unlike standard chemotherapy, which destroys both healthy and cancerous cells, immunotherapy only targets cancer cells, potentially leading to fewer side effects. In addition, because immunotherapy activates the immune system to find and destroy cancer cells, it may destroy any returning cancer without the need for further treatment.

Immunotherapy may be combined with standard treatments like chemotherapy and surgery or used alone. Several immunotherapy drugs are currently being studied in clinical trials for mesothelioma treatment.

Gene Therapy

Gene therapy changes the DNA of either cancer or healthy cells in order to fight cancer. This is done by using modified viruses to inject new genes into the cells.

Gene therapy may be used to treat cancer in several ways:

  • Changing the genes of healthy cells so they are more resistant to high doses of chemotherapy and radiation
  • Creating genes that enter cancer cells and cause them to destroy themselves
  • Creating genes that prevent cancers from forming the blood vessels that allow them to grow and survive (anti-angiogenesis)
  • Inserting genes into cancer cells that allow the body’s immune system to identify and attack them
  • Inserting genes into cancer cells that make them more vulnerable to standard therapies like chemotherapy and radiation
  • Replacing missing or non-functioning genes, such as genes that keep tumors from forming

As researchers continue to study and innovate, they may discover even more applications for gene therapy.

Currently, several gene therapy clinical trials are available for mesothelioma patients.

Photodynamic Therapy

During photodynamic therapy, a patient takes medicine that makes their cancer cells vulnerable to high-intensity light energy. Doctors then use a form of high-intensity light such as lasers to destroy the cancer. This treatment requires that doctors can see or aim toward tumors.

Virotherapy

Virotherapy reprograms viruses to treat diseases. Researchers have known for centuries that certain viruses can kill cancer, but only recent advancements in genetic engineering are finally allowing them to apply this knowledge to actual treatments.

Virotherapy comes in three main types:

  1. Oncolytic virus therapy: These naturally-occurring and lab-grown viruses infect and kill cancer cells. They may also trigger the immune system to attack the cancer.
  2. Viral gene therapy: Viral vectors are modified viruses that can be used to inject genetic material into cells and help patients fight cancer.
  3. Viral immunotherapy: During viral immunotherapy, genetically engineered viruses inject a special antigen into the immune system that helps it destroy cancer cells.

A small but increasing number of cancer patients — including mesothelioma patients — have begun to benefit from this treatment option.

Tumor Treating Fields System

The Tumor Treating Fields (TTF) system is a type of cancer treatment that uses carefully-tuned electric fields to interrupt cancer cell division and kill cancer cells. This process slows tumor growth.

TTF is given using a wearable device called the NovoTTF-200L System. The FDA has approved it to be used alongside standard chemotherapy to treat malignant pleural mesothelioma in patients who cannot undergo surgery.

Epigenetic Therapy

Epigenetics is the study of changes in living things caused by altering gene expression instead of genes, themselves. Altering gene expression may involve switching certain genes on or off, or adjusting their intensity.

In epigenetic therapy, doctors use drugs or other methods to change this gene expression in a way that helps patients fight cancer.

Epigenetic therapy is currently being used to reverse changes in cancer cells that make them more resistant to chemotherapy over time. Researchers are also trying to use epigenetic therapy to turn cancer cells back into healthy cells.

Many epigenetic therapies are currently being developed. Some clinical trials are testing the effectiveness of early epigenetic therapies, with promising results.

Cryotherapy

Cryotherapy or cryosurgery uses liquid nitrogen to freeze and destroy cancerous cells. It must be directly applied to the tumor to avoid damaging healthy tissue, but patients rarely develop side effects or complications.

Some clinical trials are testing the effectiveness of cryotherapy on mesothelioma and other cancers. Doctors hope that cryotherapy will provide a safer alternative to more aggressive cancer treatments, especially for palliation.

Alternative Mesothelioma Treatment

Alternative treatments are practices that aim to achieve the curative or palliative effects of medicine but are not or cannot be tested and proven effective. All of the below have proven health benefits, but they have not been proven to help cancer patients live longer.

However, these alternative treatments may provide some relief from the symptoms of mesothelioma and increase overall wellbeing.

Non-medical practices that may improve cancer patient wellbeing include:

  • Acupuncture
  • Aromatherapy
  • Exercise
  • Hypnosis
  • Massage
  • Meditation
  • Music therapy
  • Relaxation techniques
  • Tai chi
  • Yoga

While many people with mesothelioma find alternative therapies and other non-medical practices helpful both physically and emotionally, they are not a replacement for medical treatment. Certain practices may also be dangerous for some individuals.

Patients should ask their doctor before attempting any type of alternative treatment.

Palliative Treatment for Mesothelioma

Some mesothelioma patients, such as those with more aggressive cancer cell types and those with more advanced cancer, may be unable to undergo curative treatments. However, they can still benefit from palliative treatment options that reduce pain and discomfort.

Palliative care options for mesothelioma include:

  • Chemotherapy: Chemotherapy helps reduce the size of cancerous tumors, easing symptoms.
  • Medication: Doctors may also prescribe pain, nausea, or appetite-stimulating medication to help patients cope with symptoms.
  • Radiation: Like chemotherapy, radiation may shrink cancerous tumors and ease symptoms. Radiation often has fewer side effects.
  • Low-risk surgeries: Palliative surgery for mesothelioma may reduce fluid buildup or partially remove tumors.

Within these groups, palliative care techniques take many forms. Patients and their families should talk with their care team to determine what palliative treatment options are best for them.

Thoracentesis

Thoracentesis is a procedure in which a needle is inserted into the space between the lung lining and the chest wall. It is done to remove excess fluid, known as a pleural effusion, from the pleural space to help a patient breathe more easily.

Video-Assisted Thoracoscopic Surgery Talc Pleurodesis

Video-assisted thoracoscopic surgery (VATS) talc pleurodesis is an effective technique used to manage repeated pleural effusions.

During VATS, surgeons insert a tiny camera (thoracoscope) into one or more surgical cuts (incisions) in the patient’s chest. The surgeons then use live video to guide them in performing talc pleurodesis. During the procedure, the space between the two layers of the pleura is sealed with talc so that it can no longer fill with fluid.

Thoracoscopic surgery only requires one or more small incisions, helping mesothelioma patients recover faster.

Partial Pleurectomy

A partial pleurectomy is the surgical removal of part of the pleura.

This procedure is performed to help prevent fluid from filling the pleura and to relieve symptoms. It may also be used to help prevent repeat cases of collapsed lungs, a side effect experienced by about 10% of mesothelioma patients according to a 2018 analysis of the procedure published in the World Journal of Surgery.

Paracentesis

Paracentesis is a procedure that doctors may use for diagnosis or palliative care.

During paracentesis, a catheter or needle is inserted into the space between the lining of the abdominal wall and the lining surrounding the internal organs.

This space is then drained of fluid, potentially reducing peritoneal mesothelioma symptoms such as shortness of breath, fatigue, and loss of appetite.

PleurX Catheter

The PleurX drainage system is an FDA-approved catheter used to drain extra fluid around the lungs or abdomen — a common problem in mesothelioma patients that may cause pain and discomfort.

The PleurX catheter allows patients to manage fluid buildup without going to the hospital. Using it requires a simple surgery in which the catheter is inserted into the chest or abdomen.

Doctors leave the end of the catheter outside the body, hidden under a bandage, which patients can connect to bottles to drain fluid when they need to.

Creating a Mesothelioma Treatment Plan

A treatment plan outlines a suggested timeline of treatments, taking the individual’s physical and emotional needs into account. Patients should discuss this plan with their doctor before beginning treatment.

Treatment plans provide information on:

  • A patient’s disease
  • Treatment goals
  • Options for treatment
  • Potential side effects of treatment
  • Expected timeline of treatments

Once a mesothelioma patient is thoroughly tested and diagnosed, they will work with their care team to create a treatment plan.

Top Mesothelioma Doctors

Mesothelioma doctors specialize in diagnosing and treating mesothelioma. They are able to perform highly complex, mesothelioma-specific biopsies and surgeries that result in several more months or even years of life for many people.

Mesothelioma doctors may specialize in different areas of medicine, such as:

  • Medical oncology: Oncologists are doctors who specialize in treating and diagnosing cancer, often administering treatments like chemotherapy. Mesothelioma oncologists focus specifically on mesothelioma patients.
  • Mesothelioma pathology: Pathologists are doctors who specialize in determining the causes and effects of a disease.
  • Mesothelioma radiology: Radiologists are doctors who specialize in diagnosing and treating patients using special imaging technology such as X-rays and CT scans.
  • Mesothelioma surgery: Mesothelioma surgeons are doctors who perform surgeries such as surgical biopsies, curative procedures like EPP, and palliative surgeries for symptom relief.

Mesothelioma doctors may also sub-specialize by the type or stage of mesothelioma. When possible, patients should seek doctors who not only have experience with mesothelioma but also with their type and stage.

Here are some of the top pleural mesothelioma specialists:

  • Dr. Abraham Lebenthal: Brigham and Women’s Hospital and director of Minimally Invasive Thoracic Surgery at the VA West Roxbury Medical Center in Boston, MA.
  • Dr. Jacques-Pierre Fontaine: Moffitt Cancer Center in Tampa, FL.
  • Dr. Robert B. Cameron: Ronald Reagan UCLA Medical Center in Los Angeles, CA.
  • Dr. Taylor Ripley: Baylor St. Luke’s Medical Center in Houston, TX.

Visit the UCLA Health website to learn more about Dr. Robert Cameron.

The Mesothelioma Justice Network has no affiliation with and is not endorsed or sponsored by Dr. Robert B. Cameron. The contact information above is listed for informational purposes only. You have the right to contact Dr. Cameron directly.

Here are some of the top peritoneal mesothelioma specialists:

  • Dr. Paul Sugarbaker: Washington Cancer Institute in Washington D.C.
  • Dr. James Pingpank: UPMC Hillman Cancer Center in Pittsburgh, PA.
  • Dr. Hedy Lee Kindler: University of Chicago Cancer Center in Chicago, IL.

It may be difficult to find pericardial and testicular mesothelioma doctors, but some specialists have experience treating these rare types of mesothelioma.

Most top mesothelioma specialists in the United States work at NCI-designated cancer centers, so researching these centers may be a good place to start looking for a specialist. The Mesothelioma Applied Research Foundation also helps patients choose the best mesothelioma experts for them.

Mesothelioma Treatment Centers

Top mesothelioma cancer centers specialize in the diagnosis, treatment, and research of mesothelioma. They employ experienced mesothelioma doctors and other health professionals who work together to give patients the best treatment options available.

Like specialists, themselves, these centers may sub-specialize by mesothelioma type or stage.

For example, surgeons may be more experienced in the treatment of earlier stages, and oncologists lead the treatment of recurrent and metastatic cancers. However, all these kinds of specialists work together in the mesothelioma centers.

Top pleural mesothelioma cancer centers include:

  • Baylor Lung Institute
  • Boston VA Medical Center, West Roxbury Campus
  • Brigham & Women’s Hospital
  • H. Lee Moffitt Cancer Center

Top peritoneal mesothelioma cancer centers include:

  • Washington (D.C.) Cancer Institute at Washington Hospital Center
  • University of Chicago Comprehensive Cancer Center
  • UPMC Hillman Cancer Center

Patients should look to these and other NCI-designated mesothelioma cancer centers to maximize their chances of living as long and as well as possible. The NCI has a full list of NCI-designated cancer centers on its official website at cancer.gov.

Mesothelioma Treatment for Veterans

According to the Purple Heart Foundation, veterans make up around 33% of all Americans diagnosed with mesothelioma. Throughout much of the 20th century, asbestos-containing products were used heavily in the military. Even after the military discontinued the use of asbestos, some members deployed overseas may have been exposed to the toxic mineral.

Thankfully, the Department of Veterans Affairs (VA) provides both healthcare and compensation disability benefits for veterans with mesothelioma.

Veterans may be eligible for VA disability benefits if:

  • They were exposed to asbestos during their military service
  • They were not dishonorably discharged

While the VA may cover healthcare costs at other treatment centers, the VA has some of the top mesothelioma cancer centers and doctors in the country.

Top VA mesothelioma treatment centers include:

  • Atlanta VA Medical Center
  • Boston VA Medical Center, West Roxbury Campus
  • Bruce W. Carter VA Medical Center
  • Michael E. DeBakey VA Medical Center
  • West Los Angeles VA Medical Center

To receive VA benefits, veterans will need to file a disability compensation claim along with documents that support that they have mesothelioma and were exposed to asbestos during their service.

Common Questions About Mesothelioma Treatment

Receiving a mesothelioma diagnosis can be devastating and overwhelming, but patients and their loved ones should ask their doctor about anything they may be confused or unsure about. For non-medical help with mesothelioma, patients also have options. Being as informed as possible will help patients receive the best outcome for their cancer.

Which mesothelioma treatment is right for me?

Only you, with counsel from an experienced doctor, can determine what treatment is right for you. Your medical care team will sit down with you to help you and your loved ones determine the best course of treatment.

Which treatments you are strong enough to undertake and which will be most effective for your stage and type of cancer are central considerations, but they are not the only factors to account for.

You may wish to consider the short- and long-term side effects of various treatments, how many more months or years you may live with treatment, and your personal feelings about getting certain treatments.

How long will treatment take? What is the process?

Treatment length can vary considerably depending on what treatment you are getting, how far your mesothelioma has progressed, your overall health, whether or not you have to travel to receive treatment, and several other factors.

Your doctor will give you the best estimate of:

  • When your treatment will begin
  • How many stages or rounds of treatment are involved
  • What exactly will happen during treatment
  • How long your operation or treatment session will take

In addition to the actual treatment, you may also want to ask your doctor about how long you may have to spend in recovery between treatments and after treatment has ended.

How will mesothelioma treatment affect me?

Many mesothelioma treatments — especially curative surgeries — are serious procedures with long recovery times and potential side effects.

Surgery may require hospital stays of a week or longer, with months of recovery at home after discharge. During this time, you may not be able to carry out everyday tasks like house upkeep, exercise, and working. You may also experience side effects, such as difficulty in breathing, after curative mesothelioma surgeries.

In addition to destroying cancer cells, chemotherapy and radiation therapy may also destroy some healthy cells, leading to potential side effects. Thankfully, most chemotherapy and radiation side effects go away after treatment.

Your doctor can provide detailed information on the most common side effects and risks of your treatment options.

Are there more natural treatment options available?

Many non-medical therapies and activities may ease your pain and increase your mental, spiritual, and physical health.

However, these treatments are not substitutes for procedures that have been carefully and rigorously tested, refined, and proven effective by experts with decades of knowledge and experience.

You should never undertake any cancer treatment without your mesothelioma doctor’s approval.

How much does mesothelioma treatment cost?

The total cost of treatment for mesothelioma can reach more than $500,000. This figure does not even account for related costs such as lost wages, at-home care, and travel and lodging expenses.

However, mesothelioma financial assistance such as private or government health insurance, VA benefits, and through other means may help you lower costs.

What if I choose to go untreated?

Mesothelioma doctors will do everything they can to suggest treatments that have the best chance of improving your life expectancy and quality. However, the choice to undergo treatment is yours alone.

Some mesothelioma patients decide not to get medical treatment for emotional, religious, practical, or other reasons.

The average life expectancy for a patient who is not treated for their mesothelioma is 12 months.

Where can I learn more about mesothelioma treatment?

The first place you should turn for information about mesothelioma treatment is your mesothelioma care team. They have dedicated their lives to treating mesothelioma and are highly educated on the subject.

However, there are a number of other excellent resources you may turn to for more information.

Other resources on mesothelioma treatment include:

  • Support groups: While you should only follow the medical advice of a doctor, support group members and facilitators often share valuable mesothelioma treatment resources they have found helpful.
  • Websites: Several websites such as clinicaltrials.gov, cancer.gov, and medlineplus.gov are just a few trusted sources where you can find information on mesothelioma treatment. Clinicaltrials.gov allows you to search for available clinical trials.

You should understand exactly what your options for treatment are, the likely outcome of each treatment, and the risks and side effects involved.

The Future of Mesothelioma Treatment

As medical researchers have gained more and more insight into particular types of cancer like mesothelioma, the number of potential treatment options have exploded.

“We’re making tremendous advances in the diagnosis of mesothelioma, the staging of this disease, treatment, and research, and this is providing hope to patients and families…” – Daniel H. Sterman, Pleural Mesothelioma Pulmonologist

Several treatments, like targeted therapy, are already available to some mesothelioma patients. Other biologic therapies are quickly showing promise and bringing new hope for longer lifespans, a better quality of life, and a cure for this deadly disease.

Mesothelioma Support Team
Reviewed by:Mark Levin, MD

Certified Oncologist and Hematologist

  • Fact-Checked
  • Editor

Mark Levin, MD has nearly 30 years of experience in academic and community hematology and oncology. In addition to serving as Chief or Director at four different teaching institutions throughout his life, he is also still a practicing clinician, has taught and designed formal education programs, and has authored numerous publications in various fields related to hematology and oncology.

Dr. Mark Levin is an independently paid medical reviewer.

Stephanie KiddWritten by:

Editor-in-Chief

Stephanie Kidd works tirelessly as a dedicated advocate for the vulnerable and underrepresented. Stephanie worked as a copywriter for an agency whose focus was communicating safety procedures on construction work sites. With her extensive background in victim advocacy and a dedication to seeing justice done, Stephanie works hard to ensure that all online content is reliable, truthful and helpful.

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