Straight Talk about Mesothelioma, a blog series created by Michael T. Milano, M.D., Ph.D., a radiation oncology specialist, as a resource for mesothelioma patients and their loved ones.


If you have been diagnosed with pleural mesothelioma, your cancer is in the pleural space—the area between the lungs and the chest wall. Traditionally, surgery, radiation, and chemotherapy are the treatments used to care for patients with this type of mesothelioma. Often two or more of these therapies will be combined. Here is how the different treatment options work:

  • Surgery aims to remove the cancer, or as much of it as possible. There are several different types of surgical options:
    • Pleurectomy surgery removes the cancerous section of the chest lining and some of the surrounding tissue
    • Pneumonectomy surgery removes a lung, if the cancer has spread
    • Extrapleural pneumonectomy surgery removes a lung and its lining, along with the diaphragm and the lining around the heart
    • Pleurectomy/decortication surgery removes the lining of the lung and as much of the tumor as possible
  • Radiation therapy uses high doses of radiation to kill cancer cells and reduce the size of tumors. For mesothelioma, radiation is delivered externally via a machine.
  • Chemotherapy uses a combination of drugs to kill cancer cells. The chemotherapy may be delivered by a pill taken orally, or administered directly into the pleural cavity
    via needle.

All of these treatments have powerful side effects, but your mesothelioma care team will work with you to help you feel as comfortable as possible.

New Approaches

It is important to have hope. Research is ongoing into new types of treatments and protocols. Photodynamic therapy and proton therapy are two new technologies that are showing some promise in the treatment of pleural mesothelioma.

Next article in this series: “What Can I Expect From My Peritoneal Mesothelioma Treatment?”