For more than a decade, Mesothelioma Guide has published blogs and updated pages with data on different treatment options for mesothelioma: survival averages, safety risks, and more.
Through that time, the best approach to treating this rare and deadly cancer has always been a combination of surgery and a systemic therapy such as chemotherapy or immunotherapy. In 2026, after all the progress in developing new ways to treat cancer, the combination of surgery and systemic therapy is still the best option for patients.
A study conducted at the University of California San Francisco (UCSF) and published in JTCVS Journal analyzed the survival outcomes for different approaches to treating mesothelioma. This rare and aggressive cancer is diagnosed in approximately 2,500-3,000 people in the United States each year. The cancer most often starts in the lining of the lungs or abdominal cavity and quickly spreads to nearby organs.
Treatment options are mostly limited to surgery, chemotherapy, immunotherapy, and radiation. Most patients are diagnosed at age 65 or older, and many are not physically capable of undergoing aggressive surgery. Others are diagnosed with a stage of cancer too advanced for them to benefit from surgery. A few patients have a type of mesothelioma with cells that are too aggressive and difficult to track, which makes surgery not feasible.
For the patients who can have surgery, this is still the best way of removing most of the tumors and giving them the best chance at a long survival.
How to Best Treat Mesothelioma
Doctors at the UCSF Health Helen Diller Family Comprehensive Cancer Center, which is one of the top mesothelioma cancer centers in the United States, analyzed 432 patients diagnosed with mesothelioma. The patients in the analysis either received no treatment (198 of the 432 in this group), just surgery (25), just systemic therapy such as chemotherapy or immunotherapy (164), or a multimodal treatment approach that combined surgery with systemic therapy (45).
The average lengths of mesothelioma survival for patients in the study shows the benefit of surgery plus systemic therapy. The average survival was 27 months (2 years, 3 months), which is longer than the overall average of 14 months. The other groups of patients had shorter average survivals:
- No treatment – 5 months
- Surgery alone – 11 months
- Systemic therapy alone – 13 months
How to Treat Early Stage Mesothelioma of the Epithelioid Cell Type
In a subset of the study, scientists analyzed patients diagnosed in stage 1 or stage 2 and with a specific cell type of mesothelioma called epithelioid mesothelioma. Stage 1 and stage 2 are considered early stages of the cancer, and surgery is still a primary option. Epithelioid mesothelioma is the easiest cell type of the cancer to treat.
For these patients, surgery plus systemic therapy caused an even bigger boost to their average survival: 37 months (3 years, 1 month). The other treatment approaches were:
- No treatment – 10 months
- Surgery alone – 29 months (2 years, 5 months)
- Systemic therapy alone – 18 months (1 year, 6 months)
Learn More About Mesothelioma Treatment Options
There are two surgery options to aggressively treat the type of mesothelioma that forms in the lining of the lungs (pleural mesothelioma). There is also a surgery to aggressively treat peritoneal mesothelioma, which forms in the lining of the abdominal cavity.
Other treatment options include chemotherapy and immunotherapy. The U.S. Food and Drug Administration has approved three different immunotherapy drugs to treat pleural mesothelioma.
If you are diagnosed with mesothelioma, we invite you to learn more about your treatment options on our website. Visit this website page to learn all about the different treatments and how they can be combined to give you the best odds of survival.
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