The average age-adjusted incidence rate for black males is 16.7 per 100,000, 3.6 times that of white males. Treatment modalities include surgery, radiotherapy and chemotherapy. The current MGH program combines these 3 modalities whenever it is feasible. Both chemotherapy and radiotherapy are given preoperatively as a means to reduce local tumor burden and to eliminate possible distant microscopic metastases. Mesothelioma arising at the pleura are divided into localized and diffuse types for the purpose of therapy.
Total excision is curative procedure.
Postoperative radiotherapy is added for residual disease if total resection was not feasible. For diffuse malignant mesothelioma, total excision is rarely feasible, and postoperative chemo-radiotherapy is added. Radiation therapy is given to the region of residual disease by external bean approach. Intraoperative radiation is also feasible to the region of gross residual tumor at the time of surgery. Interesting systemic features associated with this tumor include myasthenia gravis, red cell aplasia, and hypogammaglobulinemia.