Stage I: Many patients with stage I pleural mesothelioma have their cancer removed by pleurectomy/decortication or extrapleural pneumonectomy, as described in the section "Types of Treatment for Mesothelioma." The value of adjuvant chemotherapy or radiation therapy (treatments given after surgery) for stage I mesothelioma is unproven. Radiation therapy may be used if your general health is too poor to tolerate a major operation.

Stages II, III: Treatment options include palliative and supportive care providing relief of symptoms, such as thoracentesis (to remove fluid accumulation in the chest cavity), operations to remove as much of the tumor as possible in some cases, and radiation therapy or chemotherapy aimed at easing symptoms. Cure is usually not possible for patients in these stages. Enrollment in clinical trials evaluating the newest treatment possibilities in large medical centers should be considered.

Other approaches include putting chemotherapy or radioactive drugs directly into the pleural space. This can be done simply with the doctor placing a needle into the pleural space after numbing the skin with local anesthetic. Although this only kills some of the cancer cells, it often helps slow down fluid collection.

Stage IV: Because stage IV mesothelioma cancer has spread to distant organs, a cure is not possible. If any aggressive therapy is used, such as chemotherapy and radiation therapy, the goals should be clear to you and your family. Enrollment in clinical trials evaluating the newest treatment possibilities in large medical centers should be considered.

Supportive care may be the best choice, perhaps in the setting of a good hospice program. Pain management is an important aspect of your care. It is important for you to know that medications are available to effectively treat pain due to mesothelioma. You should not hesitate to request pain medications or discuss pain control problems with your cancer care team.