Mesothelioma treatment options
Treatment is planned by a team and often combines more than one approach. The right plan depends on the type, the stage, the cell type, your overall health, and what matters most to you.
Last reviewed October 27, 2026 against the sources listed at the end of this page.
In short
- NCI lists six kinds of treatment: surgery, radiation, chemotherapy, immunotherapy, targeted therapy, and clinical trials.
- Immunotherapy with nivolumab and ipilimumab is used for advanced pleural mesothelioma.
- For peritoneal mesothelioma, surgery followed by HIPEC (heated chemotherapy in the abdomen) may be an option.
- Palliative care, which focuses on comfort and quality of life, can be given alongside any treatment.
- Ask about clinical trials early, since some have rules about earlier treatment.
How a plan is made
NCI explains that you and your cancer care team decide on a plan together. The team weighs the stage of the cancer, your overall health, and your preferences, and the plan should cover the goals of treatment, the options, likely side effects, and how long treatment will last. It is fine to ask for time to think and to bring someone with you to appointments.
Surgery
For mesothelioma in the chest, NCI describes these operations:
- Wide local excision: removing the tumor and some healthy tissue around it.
- Pleurectomy and decortication: removing part of the lining of the lungs and chest and part of the outer surface of the lung.
- Extrapleural pneumonectomy: removing a whole lung, part of the chest lining, the diaphragm, and the lining of the sac around the heart.
- Pleurodesis: using a chemical or drug to create scarring between the layers of the pleura so fluid cannot build up again.
Treatment given after surgery to lower the risk of the cancer coming back is called adjuvant therapy.
Chemotherapy
Chemotherapy uses drugs to kill cancer cells or stop them from dividing. Systemic chemotherapy travels through the bloodstream. Regional chemotherapy is placed directly into a body cavity such as the chest or abdomen. Chemotherapy is often given as a combination of drugs, and NCI notes it may be combined with the targeted drug bevacizumab.
HIPEC for peritoneal mesothelioma
Hyperthermic intraperitoneal chemotherapy (HIPEC) is used after a surgeon removes all the cancer that can be seen in the abdomen. A heated chemotherapy solution is pumped into and out of the abdomen to kill remaining cancer cells. More on the peritoneal mesothelioma page.
Immunotherapy
Immunotherapy helps your immune system fight cancer. NCI lists ipilimumab and nivolumab as immunotherapy drugs used to treat advanced mesothelioma. Others, such as durvalumab, are being studied. Your doctor may suggest biomarker tests to help predict how you might respond.
Targeted therapy
Targeted therapy drugs attack specific features of cancer cells. NCI names bevacizumab as a targeted drug used in mesothelioma, and others, such as ramucirumab, are being studied.
Radiation therapy
Radiation uses high-energy x-rays or other radiation to kill cancer cells or keep them from growing. It can be part of treatment after surgery and is also used to relieve pain and other symptoms.
Treatment by stage (pleural)
NCI's summary describes, in general terms:
- Stage I in one part of the chest lining: surgery to remove the cancer and nearby tissue, sometimes with radiation.
- Stages II to IV: immunotherapy (nivolumab and ipilimumab), combination chemotherapy with or without bevacizumab, and palliative care to control fluid and symptoms.
- Recurrent (returned) disease: treatment that was not used the first time, such as chemotherapy, immunotherapy, or both.
Clinical trials
Clinical trials test new treatments or new ways of using existing ones. Some focus on easing symptoms. NCI and ClinicalTrials.gov list open trials. It helps to ask early, because some trials only accept people who have not had certain treatments.
Comfort and support
Palliative care focuses on symptoms such as breathlessness, pain, and fatigue, and can start at diagnosis. Draining fluid, pleurodesis, an indwelling catheter, radiation, and medicines can all help. Ask your team for a palliative care referral if it has not been offered.
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Start the free reviewCommon questions
What is palliative care? Is it the same as hospice?
No. Palliative care is care focused on relieving symptoms and improving quality of life, and it can be given at any stage, alongside treatment meant to control the cancer. Hospice is a kind of palliative care for people who are no longer seeking treatment to control the disease.
Do I need to be treated at a specialist center?
Not always, but mesothelioma is rare, and some treatments, such as extensive chest surgery or cytoreductive surgery with HIPEC, are done regularly at only a limited number of centers. A second opinion from a center that treats mesothelioma often can help you weigh your options. See our treatment centers page.
Will a legal claim affect my treatment?
A legal claim does not change your medical care. Your treatment decisions are between you and your doctors. Medical records from treatment are later used as evidence of the diagnosis.
This page is general health information, summarized from the sources below. It is not medical advice. Talk with your own doctor or care team about your situation.