Mesothelioma Photodynamic Therapy

What Is Photodynamic Therapy?

Photodynamic therapy (PDT) is a cancer treatment that combines the use of light-sensitive drugs, known as photosensitizers, with a specialized light source to target and destroy cancer cells. The treatment may also be referred to as:

• Photoradiation therapy
• Phototherapy
• Photochemotherapy

Using Laser Light to Treat Mesothelioma

During PDT, the physician will inject a photosensitizing agent, or drug, into the patient’s bloodstream. This agent will circulate throughout the body and be absorbed into the mesothelioma cancer cells.

Once the light-sensitive agent is absorbed the doctor will use a fiber-optic light to project a specific wavelength of light into the area where the cancer has developed. The light will activate the agent, producing a form of oxygen that will damage and kill the cancer cells.

In pleural mesothelioma, PDT is most often used in combination with the lung-sparing pleurectomy/decortication surgery, or P/D. Once the surgeon has removed all visible tumors from the lining of the lung, a thin fiber-optic filament is then inserted into the chest cavity to activate the photosensitizer. The goal of PDT is to kill any remaining microscopic mesothelioma cells remaining in the chest cavity.

According to the National Cancer Institute, the drug-to-light interval for photodynamic therapy can take 1-3 days to:

Mesothelioma tumors stimulate the creation of new blood vessels, or angiogenesis, by producing vascular endothelial growth factor (VEGF). PDT may help inhibit this process while also destroying the blood vessels that feed the tumors. By cutting off the tumor’s supply of oxygen and nutrients, PDT can cause mesothelioma cells to die.

Photosensitive Drugs

Photofrin, also called portimer sodium, is currently the only light-sensitizing drug approved for PDT use in clinical trials for mesothelioma. The drug is non-toxic until it is activated by light, reducing side effects.

Before surgery, the patient receives an intravenous infusion of Photofrin. It is absorbed by both healthy cells and cancer cells. Eventually, the drug is released by the healthy cells and remains in the cancer cells until it is activated by a light source, destroying the cancer cells. PDT has shown that as part of a combination of treatments, such as surgery and chemotherapy, it has the potential to improve survival outcomes in pleural mesothelioma patients.

While Photofrin is approved for use in PDT in other cancers, it is not yet FDA-approved for mesothelioma.

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Benefits of Photodynamic Therapy for Mesothelioma

PDT is a form of radiation therapy that uses a drug, or a photosensitizer, with an activating light to target and kill cancer cells. This targeted approach has the potential to improve survival for mesothelioma patients. 

PDT only works on areas of the body where light can reach, such as just below the skin or along the linings of internal organs. This is why it is most effective when used during surgery. Before surgery the patient is injected with the photosensitizing agent, and during surgery all visible tumors are removed. Light is then applied to the affected area by laser beam to kill any remaining microscopic cancer cells, minimizing the damage to healthy tissue.

Improved Survival Times

PDT is a promising mesothelioma treatment option, especially when paired with mesothelioma surgery.

In another study investigating PDT with surgery, the median survival was 36 months for stage 1 and stage 2 patients.

Side Effects of Photodynamic Therapy

According to clinical trials, there are no long-term side effects from PDT. The targeted nature of the treatment leaves healthy cells mostly unaffected.

There are some short-term side effects with PDT. Healthy cells may absorb some of the photosensitizers, which leaves them susceptible to irritation from light, including sunlight. The National Cancer Institute states these effects can last up to six weeks.

Some common side effects include:

• Skin and eye sensitivity (burning sensation) to bright artificial light and sunlight
• Skin changes (redness, itchiness, swelling, blisters and even scaring)
• Swelling in the treated area

Sunscreen does not protect against these effects. Chances of irritation depends on where doctors inject the photosensitive drug.

Other side effects are often related to the area being treated:

• Cough
• Swallowing difficulty
• Shortness of breath
• Painful breathing
• Abdominal pain

How Virotherapy Helps With Photodynamic Therapy

Virotherapy is an emerging treatment for mesothelioma that uses genetically modified viruses to selectively infect and destroy mesothelioma cells while sparing healthy tissue.

Researchers are also studying virotherapy as a way to precisely deliver other cancer therapies, including PDT.

With traditional PDT, a photosensitizer drug is given systemically, which means it circulates throughout the body and can be absorbed by both healthy cells and cancer cells. This widespread distribution can lead to temporary light sensitivity, requiring patients to avoid sunlight and certain indoor lighting until the drug clears from the healthy tissues.

Scientists are investigating whether engineered viruses can deliver the photosensitizing drug directly to mesothelioma cells. By targeting the tumors more directly, this approach may reduce exposure of healthy cells to the photosensitizer, potentially minimizing side effects such as light sensitivity and damage to normal tissue while improving the effectiveness of PDT.

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Intraoperative Photodynamic Therapy for Mesothelioma

PDT has not been shown to be effective as a stand-alone treatment for mesothelioma because of the way the disease grows and spreads. Mesothelioma often spreads as multiple tumor nodules across the lining of the chest or abdominal cavity, making it difficult for any non-surgical therapy to eliminate all cancer cells.

Surgery also has limitations and challenges, since the microscopic, scattered tumor cells can remain after all visible tumors are removed. This is where intraoperative PDT offers a clear advantage to this problem. 

After surgeons remove all visible tumors, they apply a laser light to the surgical area, activating the photosensitizing drug that has been absorbed by the remaining cancer cells. This approach targets microscopic cancer cells that may be left behind after surgery, with the goal of reducing the risk of recurrence. 

During intraoperative PDT, doctors apply a laser light directly into the chest cavity to activate  the photosensitizer. This produces a reaction that destroys mesothelioma cells while minimizing damage to surrounding healthy tissue, and provides direct access to the disease location while surgeons resect the disease through surgery.

PDT generally has fewer systemic side effects than other treatments because the effects are localized to the area exposed to the activating light. However, some patients may still experience temporary light sensitivity until the photosensitizer has cleared the tissues.

Mesothelioma Survival From Intraoperative Photodynamic Therapy

Dr. Joseph Friedberg, a specialist at Temple Health in Philadelphia, Pennsylvania, authored a paper on the use of intraoperative PDT for the treatment of pleural mesothelioma. He explained that radical pleurectomy with decortication (P/D) is the preferred operation. This surgery removes the:

• Pleura (where pleural mesothelioma forms)
• Part or all of the diaphragm (muscle beneath the lungs) 
• Pericardium (lining of the heart)

Prior to surgery, the patient will receive an IV injection of a non-toxic photosensitizing agent. Once the tumor removal part of the surgery finishes, PDT begins and lasts around one hour. The surgeon will carefully position the laser light to make sure that all surfaces inside the chest cavity will receive the prescribed dose of light waves to activate the photosensitizer. This produces a chemical reaction that causes the remaining microscopic mesothelioma cells to die.

Dr. Friedberg and his colleagues conducted a study of radical P/D with PDT. Around 80% of the 14 patients survived for at least four years after surgery, which is astounding.

“Killing cancer cells with PDT has been shown to be one of the most effective ways to stimulate a tumor-directed immune response with an autologous tumor vaccine,” Dr. Friedberg wrote. “Clearly all operations for malignant pleural mesothelioma, especially lung-sparing operations, leave behind cancer cells. The possibility exists, therefore, that these PDT-treated cells that are left behind may be inducing this type of vaccine effect.”

Dr. Friedberg’s findings suggest that further testing on the stimulation of immune responses in tumors could lead to the development of new treatments for mesothelioma.

Ongoing Research Involving Mesothelioma Photodynamic Therapy

Roswell Park Cancer Institute in Buffalo, New York has multiple studies looking into the use of photodynamic therapy to kill microscopic mesothelioma cells – the cells that remain after surgical tumor removal.

In 2014, researchers at the hospital teamed with the University of Pennsylvania’s Abramson Cancer Center in a study. The patients in the study received the photosensitive drug Photofrin one day before radical (extensive) pleurectomy with decortication surgery.

During surgery, doctors applied a PDT laser light directly into the chest cavity. The researchers compared this method to adjuvant intravenous chemotherapy, a standard treatment option after mesothelioma surgery. The trial was suspended in September 2020 due to the COVID-19 pandemic.

In 2018, Roswell Park Cancer Institute opened another trial investigating intraoperative photodynamic therapy for mesothelioma. Doctors plan to administer a photosensitive drug for 3-5 minutes and then perform intraoperative PDT 1-2 days later.

Sources & Author

1. Photodynamic therapy (PDT). American Cancer Society. Retrieved from: https://www.cancer.org/treatment/treatments-and-side-effects/treatment-types/radiation/photodynamic-therapy.html. Accessed: 07/14/2026.
2. Photodynamic Therapy to Treat Cancer. National Cancer Institute. Retrieved from: https://www.cancer.gov/about-cancer/treatment/types/surgery/photodynamic-fact-sheet. Accessed: 07/14/2026.
3. Concordia Healthcare Corp Announces First Patients Enrolled In Phase 2 Clinical Trial Using Photodynamic Therapy With PHOTOFRIN(R) For Patients With Mesothelioma. Biospace. Retrieved from: https://www.biospace.com/article/releases/concordia-healthcare-corp-announces-first-patients-enrolled-in-phase-2-clinical-trial-using-photodynamic-therapy-with-photofrin-r-for-patients-with-m/. Accessed: 07/14/2026.
4. Phase II Trial of Radical Pleurectomy With or Without Intraoperative PDT for Malignant Pleural Mesothelioma (MPM-PDT). Clinicaltrials.gov. Retrieved from: https://clinicaltrials.gov/ct2/show/NCT02153229. Accessed: 07/14/2026.
5. Light Dosimetry for Photodynamic Therapy With Porfimer Sodium in Treating Participants With Malignant Mesothelioma or Non-Small Cell Lung Cancer With Pleural Disease Undergoing Surgery. Clinicaltrials.gov. Retrieved from: https://clinicaltrials.gov/ct2/show/NCT03678350. Accessed: 07/14/2026.
6. Radical pleurectomy and photodynamic therapy for malignant pleural mesothelioma. Annals of Cardiothoracic Surgery. Retrieved from: https://www.annalscts.com/article/view/1214/1605. Accessed: 07/14/2026.
7. Photodynamic Therapy for Lung Cancer and Malignant Pleural Mesothelioma. Seminars in Oncology. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4272687/. Accessed: 07/14/2026.
8. Targeted Photodynamic Virotherapy Armed with a Genetically Encoded Photosensitizer. Molecular Cancer Therapeutics. Retrieved from: https://pubmed.ncbi.nlm.nih.gov/26625896/. Accessed: 07/14/2026.
9. Photodynamic therapy and mesothelioma. Roswell Park Cancer Institute. Retrieved from: https://www.roswellpark.org/cancertalk/202303/photodynamic-therapy-mesothelioma. Accessed: 07/14/2026.

About the Writer, David Statman

David Statman is a Content Writer for Mesothelioma Guide. He received both his bachelor's and master's in journalism from West Virginia University, and has been in medical publishing since January 2022. He previously worked in sports journalism, primarily reporting on West Virginia sports for a number of publications.

He lives in Delaware with his wife, dog and two cats, and avidly competes as a professional wrestler in the Philadelphia area.