The short answer
Mesothelioma treatment depends on type, stage, cell type, and overall health. Options include surgery to remove or reduce the tumor, chemotherapy (often pemetrexed with a platinum drug), and immunotherapy combinations, which have improved outcomes for advanced disease. Legal and compensation questions related to asbestos exposure are separate from medical care.
Treatment for mesothelioma depends on the type (pleural or peritoneal), stage, cell type, and a person's overall health.
Surgery — such as pleurectomy/decortication or extrapleural pneumonectomy for pleural disease — is an option when the tumor can be substantially removed.
Standard first-line chemotherapy combines pemetrexed with a platinum drug like cisplatin or carboplatin.
Immunotherapy combining nivolumab and ipilimumab is an option for advanced pleural mesothelioma and has shown longer survival than chemotherapy alone in clinical trials.
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The simple version
This page is for people with mesothelioma and those who care for them. It gives an overview of the main treatments.
Mesothelioma treatment depends on several things:
- The type: pleural (in the chest lining) or peritoneal (in the belly lining)
- The stage
- The cell type
- Your overall health
Most plans use more than one approach. This cancer is rare. Care at a center that treats it often can help make sure every good option is considered.
Surgery
Surgery is used when most of the tumor can be taken out.
- Pleurectomy and decortication takes out the pleural lining and any tumor the surgeon can see. It leaves the lung in place.
- Extrapleural pneumonectomy is a bigger operation. It takes out a whole lung and the lining around it. It carries a higher risk of death from surgery than pleurectomy and decortication.
- For peritoneal mesothelioma, surgery takes out tumor from the belly. Heated chemo may then go straight into the belly during that same operation. This is known as HIPEC.
Chemotherapy
The usual first choice is pemetrexed with a platinum drug. That drug is cisplatin or carboplatin. The pair has been shown to help people live longer than cisplatin alone.
Immunotherapy
Two immune drugs can be given together for advanced pleural disease. They are nivolumab and ipilimumab. In trials, the pair led to longer survival than chemo alone for many people.
Radiation and combined approaches
Radiation can ease pain and other symptoms. It can also join a wider plan with surgery and drugs, mostly for pleural disease. Centers that focus on this cancer usually lead such plans. Some are offered through clinical trials.
A note on asbestos and legal questions
Mesothelioma is strongly linked to past asbestos exposure. There are legal and money routes for people who have it, such as asbestos trust funds and lawsuits. This page covers medical care only. Claims, payouts, and the choice of a fund or lawyer are legal matters. Ask a lawyer who handles asbestos cases.
When to get help sooner
Surgery, chemotherapy, and immunotherapy for mesothelioma all carry risks. Watch for these signs during and after treatment.
- Call 911 or go to an emergency department if you are struggling to breathe, your breathlessness gets suddenly worse, you have severe chest pain, you are coughing up blood, or one leg becomes swollen, red, and painful. Do not drive yourself.
- Call your doctor immediately if you have a temperature of 100.4°F (38°C) or higher, or shaking chills, while you are having chemotherapy. Chemotherapy lowers the white cells that fight infection, and CDC treats a fever at this point as a medical emergency, telling patients to phone their doctor without delay.
- Call your care team the same day if a surgical wound or drain site is red, hot, swollen, or leaking.
- Call your care team within a day or two if you have a new or worse cough, belly pain or swelling, ongoing nausea and vomiting, you cannot keep fluids down, or you notice a new rash, diarrhea, or unusual tiredness after immunotherapy.
Do not stop, skip, or change the dose of any of your medicines on your own. Call your team first.
Sources
- National Cancer Institute — Malignant Mesothelioma Treatment (PDQ®) Patient Version
- National Cancer Institute — Malignant Mesothelioma Treatment (PDQ®) Health Professional Version
- National Cancer Institute — Symptoms of Mesothelioma
- CDC — Watch Out for Fever (Preventing Infections in People With Cancer)
Common questions
Is mesothelioma curable?
Treatment is generally not curative except for some localized disease. For most people, especially with more advanced disease, treatment focuses on controlling the cancer, easing symptoms, and extending life as long as possible, sometimes for a meaningful period of time. Your care team can speak to your specific situation.
What surgery is used for mesothelioma?
For pleural mesothelioma, options include pleurectomy and decortication (removing the lining and any visible tumor while leaving the lung in place) or extrapleural pneumonectomy (removing the lung along with the lining), a riskier operation. For peritoneal mesothelioma, surgery to remove visible tumor is sometimes combined with heated chemotherapy delivered directly into the abdomen (HIPEC).
What chemotherapy is used?
The standard first-line combination is pemetrexed with a platinum drug, usually cisplatin or carboplatin. This combination has been shown to extend survival compared with cisplatin alone.
What about immunotherapy?
A combination of two immunotherapy drugs, nivolumab and ipilimumab, is an option for advanced pleural mesothelioma. In a clinical trial, this combination led to longer survival than chemotherapy.
Should I look into legal help for asbestos exposure?
Many people diagnosed with mesothelioma do explore legal and compensation options related to past asbestos exposure, since funds and legal claims exist specifically for this purpose. That said, this is a legal question, not a medical one — this page focuses on medical care, and legal or compensation questions are best discussed with a qualified attorney who handles asbestos-related claims.
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Last updated: 2026-09-29Next planned review: 2027-08-03
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Cancer Explained does not originate medical claims. Every page restates guidance already published by the National Cancer Institute, the CDC, the USPSTF and the FDA, in plain language, with the source cited so you can check the original yourself. AI does the translating and organizing; automated checks test claims, citations, clarity and safety before anything publishes, and this is translation and navigation, not clinical judgment. Nothing here is personal medical advice, and no page can account for your particular situation.
Editorial status: Source checked — This page was written with AI assistance and then compared with the sources listed on it, looking for statements those sources do not back up. That check is not a sentence-by-sentence record and can miss errors. It is not a medical review, and it does not confirm the page is complete or right for your situation.
Human medical review: not completed. Pages here are not signed off by a clinician before they publish. That is not an oversight we are quietly working around: we restate published guidance and cite it, so the authority belongs to the source rather than to us, and every page names where its claims come from — you can verify us instead of trusting us. Where a volunteer clinician has reviewed a page, their name and credentials appear on it; where no name appears, no clinician has checked it. We are glad to have reviewers and are recruiting them, and we do not hold pages back waiting for one. Use this site to understand your situation and to ask better questions of the people treating you.
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