Mesothelioma Treatment Options

The treatment of mesothelioma depends on many factors such as location of the cancer, the stage of the disease, patient’s age and overall health of the patient. Standard treatment options can include surgery, chemotherapy and radiation procedures, and/or a combination of these therapies depending on each patient’s circumstance.

There is no known cure for mesothelioma, and the treatment procedures mentioned above can only provide temporary relief from symptoms and in some cases may prolong survival.  Chemotherapy and radiation procedures can limit the chances of the tumor(s) metastasizing or spreading to another part of the body. These treatments are not fool proof and will not cure mesothelioma.

Some of the treatments available include:

  • Surgery
    There are a variety of surgeries that are used to treat mesothelioma. The tumors associated with mesothelioma tend to be more difficult to remove than a lung cancer tumor.  There are two general categories of surgery used to treat mesothelioma:
  • Surgical Options
    These are surgical treatments that seek to remove the disease from the body and prevent it from recurring.  Treatment includes pleurectomy/decortication, which is a surgical removal of the pleura, the lining of the lungs. Another surgical procedure is extra-pleural pneumonectomy, which is the removal of the pleura as well as the entire lung and in some cases, partial removal of the diaphragm and pericardium. This is a radical treatment and should only be done by a medical center that specializes in this type of treatment.
  • Chemotherapy
    Chemotherapy is a drug treatment plan designed to destroy the cancer cells and prevent them from spreading. Drugs are placed directly in the bloodstream. For mesothelioma, the goal of chemotherapy is not to cure the cancer, but to shrink the tumors and prevent the spread of the disease. Drugs that have proven useful include doxorubicin, gemcitabine, cisplatin, carboplatin, epirubicin, cyclophosphamide, ifosfamide, vinorelbine, paclitaxel, and methotrexate.
  • Radiation
    Intense x-rays are used to shrink tumors and destroy cancer cells. Radiation is effective for treating localized tumors and relieving pain, but can be difficult to use without causing further damage to the lungs, heart, and liver.
  • ADI-PEG20 (Pegargiminase-Chemotherapy) 
    A new treatment is giving hope to cancer patients diagnosed with Nonepithelioid Pleural mesothelioma.  JAMA Oncology published the results of a clinical trial study in February 2024 which showed that when patients combined chemotherapy with the addition of ADI-PEG20, the overall survival rate increased by 1.6 months, and quadrupled the survival at 36 months compared to placebo-chemotherapy. The study was conducted in 43 centers in five countries (UK, US, Australia, Italy & Taiwan) between 2017 and 2021 and with 12 months’ follow-up.

Pleural mesothelioma is a form of mesothelioma cancer that affects the lining of the lungs. Malignant Pleural Mesothelioma has one of the lowest 5-year survival rate of any solid cancer, estimated at 5% to 10%. Generally caused by exposure to asbestos in the workplace, mesothelioma is an aggressive cancer that is notoriously hard to treat.

This study follows the discovery that mesothelioma cells lack a protein called argininosuccinate synthetase 1 (ASS1), which enables cells to manufacture the amino acid arginine. When tumor cancer cells cannot manufacture their own arginine, their growth is thwarted through arginine deprivation.  This breakthrough led to the development of ADI-PEG20, a drug that works by depleting arginine levels in the bloodstream.  Because tumors cannot manufacture their own arginine, the lack of this amino acid causes the cancer cells to essentially starve, and the tumor’s growth is thwarted. 

Although further research is needed into the biology of mesothelioma to uncover its vulnerabilities, the addition of this amino acid deprivation strategy, and the use of ADI-PEG20 in addition to chemotherapy, is very encouraging in cancer patients diagnosed with pleural mesothelioma.


Non-Traditional Therapies:

  • Photodynamic Therapy
    Patients take drugs to make their bodies particularly sensitive to light. Fiber optic cables are then surgically implanted in the body and light energy is directed towards the tumor. This radical surgical treatment is still considered experimental for mesothelioma treatment.
  • Gene Therapy
    Genes are inserted directly into tumors, making the cancer cells highly susceptible to certain drugs. The patient takes the drug and it directly impacts the cancer cells which have been genetically altered so that they will be killed by the drugs. This treatment is in clinical trials.
  • Immunotherapy
    The body’s own immune system is ‘taught’ to fight the cancer cells using biological response monitors. Clinical studies are currently underway for this therapy.

Lung Cancer Treatment Options

  • Surgical Treatments
    If the tumor is contained within the lung the surgeons can perform either a lobectomy or a wedge resection with involves the surgical removal of a portion of your lung containing the tumor.
  • Non-Surgical Treatments
    If the tumor is inoperable, the surgeon may recommend chemotherapy or radiation to shrink the tumor.  Chemotherapy and radiation therapy are performed by an oncologist, a medical doctor specializing in cancer treatment.
  • Immunotherapy
    Oncologists have also tried immunotherapy, through a drug called KEYTRUDA®  You should ask your treating cancer doctor about the potential benefits of KEYTRUDA® versus chemotherapy.

Palliative Procedures to Treat Mesothelioma and Lung Cancer

  • Palliative Procedures
    This treats the symptoms, focusing on making the patient comfortable instead of treating the disease. Some options include chest tube drainage and pleuroperitoneal shunt.

If you or a loved one has been diagnosed with mesothelioma, lung cancer, or another asbestos-related disease, contact us today for a free case evaluation.