Treatment for mesothelioma
Radiotherapy uses high energy x-rays to destroy cancer cells.
You usually have . This means using radiation from a machine outside the body.
You might have radiotherapy to reduce the symptoms of pleural mesothelioma. The treatment may also slow down the growth of the cancer.
You might have radiotherapy after surgery for pleural mesothelioma. This is called adjuvant radiotherapy. It aims to stop or delay the cancer from coming back.
You don't usually have radiotherapy for peritoneal mesothelioma. This is because it causes too many side effects.
Find out about treatment options for peritoneal mesothelioma
You have radiotherapy in a hospital radiotherapy department. You usually have it as an outpatient each weekday. You might only have 1 or 2 treatments. Or you might have a course of treatment over a few days or weeks, depending on your situation.
The radiotherapy team plan your external radiotherapy before you start treatment. This means working out the dose of radiotherapy you need and exactly where you need it.
Your planning appointment takes from 15 minutes to 2 hours.
You usually have a planning CT scan in the radiotherapy department.
The scan shows the cancer and the area around it. You might have other types of scans or x-rays to help your treatment team plan your radiotherapy. The plan they create is just for you.
Your radiographers tell you what is going to happen. They help you into position on the scan couch. You might have a type of firm cushion called a vacbag to help you keep still.
The CT scanner couch is the same type of bed that you lie on for your treatment sessions. You need to lie very still. Tell your radiographers if you aren't comfortable.
You might need an injection of contrast into a vein in your hand. This is a dye that helps body tissues show up more clearly on the scan.
Before you have the contrast, your radiographer asks you about any medical conditions or allergies. Some people are allergic to the contrast.
Once you are in position your radiographers put some markers on your skin. They move the couch up and through the scanner. They then leave the room and the scan starts.
The scan takes about 5 minutes. You won't feel anything. Your radiographers can see and hear you from the CT control area where they operate the scanner.
The radiographers make pin point sized tattoo marks on your skin. They use these marks to line you up into the same position every day. The tattoos make sure they treat exactly the same area for all of your treatments. They may also draw marks around the tattoos with a permanent ink pen, so that they are clear to see when the lights are low.
The radiotherapy staff tell you how to look after the markings. The pen marks might start to rub off in time, but the tattoos won’t. Tell your radiographer if that happens. Don't try to redraw them yourself.
You might have to wait a few days or weeks before you start treatment.
During this time the and your radiotherapy doctor (clinical oncologist) decide the final details of your radiotherapy plan. They make sure that the cancer will receive a high dose and nearby areas receive a low dose. This lowers the side effects you might get during and after treatment.
Read more about radiotherapy planning
Radiotherapy machines are very big and could make you feel nervous when you see them for the first time. The machine might be fixed in one position. Or it might rotate around your body to give treatment from different directions. The machine doesn't touch you at any point.
Before your first treatment, your will explain what you will see and hear. In some departments, the treatment rooms have docks for you to plug in your phone or personal device. So you might be able to listen to an audiobook, a podcast or music during the treatment.
The radiographers help you to get onto the treatment couch. You might need to raise your arms over your head.
The radiographers line up the radiotherapy machine using the marks on your body. Once you are in the right position, they leave the room.
You need to lie very still. Your radiographers might take images (x-rays or scans) before your treatment. This is to make sure that you're in the right position. The machine makes whirring and beeping sounds. You won’t feel anything when you have the treatment.
Your radiographers can see and hear you on a CCTV screen in the next room. They can talk to you over an intercom and might ask you to hold your breath or take shallow breaths at times. You can also talk to them through the intercom or raise your hand if you need to stop or if you're uncomfortable.
This type of radiotherapy won't make you radioactive. It's safe to be around other people, including pregnant women and children.
You might have to travel a long way each day for your radiotherapy. This depends on where your nearest cancer centre is. This can make you very tired, especially if you have side effects from the treatment.
You can ask your radiographers for an appointment time to suit you. They will do their best, but some departments might be very busy. Some radiotherapy departments are open from 7 am till 9 pm.
Car parking can be difficult at hospitals. Ask the radiotherapy staff if you are able to get free parking or discounted parking. They may be able to give you tips on free places to park nearby.
Hospital transport may be available if you have no other way to get to the hospital. But it might not always be at convenient times. It is usually for people who struggle to use public transport. Or who have any other illnesses or disabilities. You might need to arrange hospital transport yourself.
Some people are able to claim back a refund for healthcare travel costs. This is based on the type of appointment and whether you claim certain benefits. Ask the radiotherapy staff for more information about this and hospital transport.
Some hospitals have their own drivers and local charities might offer hospital transport. So do ask if any help is available in your area.
If you have a short course of radiotherapy treatment for only a few days, you might have very few side effects. You are likely to have more side effects if you have treatment for a couple of weeks.
Side effects tend to start a week after the radiotherapy begins. They gradually get worse during the treatment and for a couple of weeks after the treatment ends. But they usually begin to improve after around 2 weeks or so.
Everyone is different and side effects can vary from person to person. Side effects can include:
Your skin might go red or darker in the treatment area. This can vary depending on your skin tone.
You might also get slight redness or darkening on the other side of your body. This is where the radiotherapy beams leave the body.
The red or darker areas can feel sore. This may start after you finish your radiotherapy treatment. Your radiographers may give you creams to soothe your skin. The soreness usually goes away within 2 to 4 weeks of ending the treatment. But your skin might always be slightly darker in that area.
Tell the radiotherapy staff if you notice any skin changes
Find out about caring for your skin
You might feel tired during your treatment. It tends to get worse as the treatment goes on. You might also feel weak and lack energy. Rest when you need to.
Tiredness can carry on for some weeks after the treatment has ended. But it usually improves gradually.
Various things can help you to reduce tiredness and cope with it, such as exercise. Some research has shown that taking gentle exercise can give you more energy. It's important to balance exercise with resting.
Get tips on coping with tiredness
You may lose some body hair in the treatment area. This may grow back a few weeks after treatment finishes. But sometimes it doesn't. Your doctor will talk to you about this before you start treatment.
Some of the side effects you may have depend on which part of your chest is being treated. If it is:
your lower chest, you may feel sick or have diarrhoea
your upper chest, you may develop a dry, sore throat
These side effects are usually controllable with anti sickness or anti diarrhoea medicines. Ask your radiotherapy doctor for these if you need them. Any side effects tend to get worse towards the end of your treatment. Then they gradually clear up after it has finished.
While you are having radiotherapy, your radiographer or a physiotherapist may ask you to do particular exercises. These exercises help to prevent stiffness and aching in your chest and shoulder, which some people get after their treatment ends.
Last reviewed: 10 Nov 2026
Next review due: 10 Nov 2029
You might have a build up of fluid around the lung which can cause breathlessness. Pleurodesis is a treatment for this.
You have regular check up appointments after treatment for mesothelioma. This is called follow up.
Coping with mesothelioma symptoms and treatment can be difficult. There are things you can do and people who can help you to cope. You might be able to claim compensation if you know you were exposed to asbestos at work.
Find out more about research and clinical trials for mesothelioma.
Mesothelioma is a cancer that most commonly starts in the sheets of skin-like tissue that cover each lung (the pleura). More rarely it starts in the sheet of tissue in the abdomen that covers the digestive system organs (the peritoneum).
