Conventional therapies are of little use in Mesothelioma Treatment. The survival time after diagnosis is around 6 to 12 months. The spread of malignant cells to the underlying tissue and other organs in the pleural cavity, the pleural cavity encouraging local metastasis by exfoliated cells, the long inactive period between asbestos exposure and development of the disease are among the chief reasons for the malignancy not responding to treatments.

Surgery for mesothelioma may be performed to relieve pain and discomfort caused by the tumor or to cure the patient. Palliative surgery is typically done in cases where the tumor has already spread beyond the mesothelium and is difficult to completely remove or in cases where the patient is too ill to tolerate a more extensive operation. Curative surgery is offered when the patient is in good health and the tumor is thought to be localized and can be completely removed.

Mesothelioma is highly resistant to radiation therapy and chemotherapy. These treatments are mainly used relieve symptoms due to tumor metastasis. The Food and Drug Administration approved in February 2004 the use of pemetrexed, brand named Alimta, for the treatment of malignant pleural mesothelioma.

Mesothelioma has reacted positively to certain treatments using immunotherapy. The attempt to boost immune response using intrapleural inoculation of Bacillus Calmette-Gurin (BCG) had not effect in Mesothelioma treatment and the patients who underwent this treatment had several side effects. Immunotherapy involving interferon alpha has been able to reduce tumor by 50% in certain patients. The side effects of this treatment were minimal.

Heated intraoperative intraperitoneal chemotherapy, a procedure developed by Paul Sugarbaker at the Washington Cancer Institute is a breakthrough in Mesothelioma treatment. He is able to remove a larger amount of tumor by the direct administration of a chemotherapy agent in the abdomen. In this treatment, high concentrations of selected drugs can be administrated into the abdominal and pelvic surfaces. The fluid used is perfused for 60 to 120 minutes and then drained out. When the drug is heated to 40 to 48 degree Celsius, it increases the penetration of drugs into tissues. The heating also damages the malignant cells.

New treatment approaches such as gene therapy are under clinical trials. Age, contributing health problems, or advanced state of disease may make aggressive treatment impossible. In these cases, palliative care which treats the symptoms is ideal.