Brigham and Women's Hospital: 40+ Years Pioneering Mesothelioma Surgery With 51% 5-Year Survival

Brigham and Women's Hospital in Boston has achieved 5-year survival rates reaching 51% for select mesothelioma patients through its pioneering multimodal treatment approach combining surgery, chemotherapy, and radiation. As the birthplace of modern mesothelioma surgery and home to the International Mesothelioma Program, BWH has treated more mesothelioma patients than nearly any other institution in the world over the past four decades.

Key Facts About Brigham and Women's Hospital Mesothelioma Program

• 51% 5-year survival achieved for selected epithelioid mesothelioma patients receiving multimodal treatment at BWH
• 40+ years of dedicated mesothelioma surgical experience since Dr. Sugarbaker established the program
• Harvard Medical School affiliation providing access to the latest research and emerging treatments
• 2 surgical approaches: extrapleural pneumonectomy (EPP) and pleurectomy/decortication (P/D) tailored to individual patients
• International Mesothelioma Program dedicated exclusively to mesothelioma research and patient care
• Active clinical trials offering immunotherapy, targeted therapy, and novel surgical techniques not available elsewhere
• Multidisciplinary team of 15+ specialists coordinating each patient's care through weekly tumor board conferences
• NCI-designated Dana-Farber/Brigham Cancer Center providing comprehensive cancer research infrastructure
• Both pleural and peritoneal mesothelioma treated with specialized surgical protocols for each disease type
• Nationwide referrals accepted from across the United States and internationally for second opinions and treatment

Why Is Brigham and Women's Hospital Considered a World Leader in Mesothelioma Treatment?

Brigham and Women's Hospital earned its reputation as a mesothelioma treatment leader through decades of surgical innovation, published research, and documented patient outcomes that consistently exceed national averages. The hospital's International Mesothelioma Program was the first of its kind — a dedicated center bringing together every specialty needed for comprehensive mesothelioma care under one institutional umbrella.[1]

The late Dr. David Sugarbaker established BWH as the epicenter of mesothelioma surgery by developing and refining the extrapleural pneumonectomy procedure. His work demonstrated that aggressive surgical intervention combined with chemotherapy and radiation could dramatically extend survival for patients previously given months to live. The protocols he developed remain foundational to mesothelioma treatment worldwide.

BWH's affiliation with Harvard Medical School and the Dana-Farber Cancer Institute provides a research infrastructure that few institutions can match. This academic environment drives continuous improvement in treatment approaches, with BWH surgeons and oncologists publishing more mesothelioma research papers annually than virtually any other single institution.[5]

"The combination of surgical volume, research output, and institutional commitment to mesothelioma makes Brigham and Women's Hospital truly unique. Patients treated here benefit from four decades of accumulated expertise in a disease where experience directly impacts outcomes."

— Dr. Raphael Bueno, Chief of Thoracic Surgery, Brigham and Women's Hospital

What Surgical Options Does BWH Offer for Pleural Mesothelioma?

BWH offers two primary surgical approaches for pleural mesothelioma: extrapleural pneumonectomy (EPP) and pleurectomy/decortication (P/D). The choice between procedures depends on disease stage, cell type, patient health, lung function, and other clinical factors evaluated by the surgical team during comprehensive preoperative assessment.[3]

Extrapleural pneumonectomy involves removing the affected lung along with the surrounding pleural lining, diaphragm, and pericardium. BWH pioneered this aggressive approach under Dr. Sugarbaker, demonstrating that complete macroscopic tumor resection could achieve long-term survival in patients with early-stage epithelioid mesothelioma. The procedure requires excellent overall health and lung function in the remaining lung.

Pleurectomy/decortication removes the pleural lining and all visible tumor while preserving the lung itself. This lung-sparing approach has gained increasing prominence at BWH and other centers as surgical techniques have improved. P/D typically involves shorter hospital stays, fewer complications, and preserved quality of life while still achieving meaningful survival benefit when combined with chemotherapy and radiation.

BWH's thoracic surgical team evaluates each patient individually through a multidisciplinary tumor board conference before recommending a surgical approach. This collaborative decision-making process ensures that surgical recommendations reflect the combined expertise of surgeons, oncologists, radiologists, and pathologists — not just a single physician's preference.

"There is no one-size-fits-all surgery for mesothelioma. The right procedure depends on the individual patient's disease characteristics and overall health. At Brigham, we have the experience and capability to offer both EPP and P/D, and we choose the approach that gives each patient the best chance."

— Dr. Abraham Lebenthal, Thoracic Surgeon, Brigham and Women's Hospital

How Does Multimodal Treatment Achieve 51% 5-Year Survival?

BWH's published survival data showing 5-year rates reaching 46-51% reflect outcomes for patients receiving multimodal therapy — the combination of surgery, chemotherapy, and radiation therapy delivered in a carefully sequenced treatment protocol. No single treatment modality alone achieves these results; the combination is essential to controlling mesothelioma across multiple fronts simultaneously.[3]

The typical BWH multimodal protocol begins with chemotherapy to shrink the tumor before surgery, followed by surgical resection to remove all visible disease, then radiation to treat microscopic residual cells. This sequencing maximizes the effectiveness of each treatment phase while managing side effects and recovery between phases.

Patient selection significantly influences survival outcomes. The 51% 5-year survival rate applies specifically to patients with epithelioid cell type — the most common and most treatment-responsive mesothelioma variant — who were healthy enough for aggressive multimodal therapy. Patients with sarcomatoid or biphasic histology, advanced stage disease, or significant comorbidities may have different expected outcomes.

These results dramatically exceed the national median survival for mesothelioma of approximately 12-18 months, demonstrating the substantial survival benefit achievable through specialized treatment at high-volume centers. The difference between median national survival and BWH outcomes underscores why seeking treatment at an experienced mesothelioma treatment center is critical.[4]

What Clinical Trials Are Available at BWH?

BWH maintains an active mesothelioma clinical trials program offering access to experimental treatments years before they become widely available. As a Harvard Medical School teaching hospital with NCI-designated cancer center status through the Dana-Farber/Brigham Cancer Center, BWH participates in and leads cutting-edge research that shapes future treatment standards.[2]

Current and recent clinical trial offerings at BWH include immunotherapy combinations such as checkpoint inhibitors paired with chemotherapy or other immunotherapy agents, targeted therapies aimed at specific molecular characteristics of mesothelioma tumors, and novel surgical techniques including intraoperative therapies delivered directly to the surgical site.

Patients interested in clinical trials at BWH undergo comprehensive evaluation to determine trial eligibility. Not every patient qualifies for every trial, but the breadth of BWH's trial portfolio means that many patients find at least one trial appropriate for their specific disease characteristics. Clinical trial participation provides access to promising treatments while contributing to research that benefits future patients.

BWH researchers have been instrumental in advancing mesothelioma immunotherapy, investigating how the immune system can be harnessed to fight mesothelioma. Several immunotherapy approaches currently in widespread use were studied and validated at BWH before gaining broader adoption, reflecting the hospital's role as a treatment innovator rather than simply a treatment provider.

What Should Patients Expect When Seeking Treatment at BWH?

The treatment process at BWH typically begins with a comprehensive evaluation including imaging studies, pathology review, pulmonary function testing, and cardiac assessment. The International Mesothelioma Program coordinates all evaluations efficiently, often completing the full workup within one to two days for patients traveling from out of state.

Following evaluation, each patient's case is presented at a weekly multidisciplinary tumor board conference where thoracic surgeons, medical oncologists, radiation oncologists, pathologists, and pulmonologists collectively review findings and develop a treatment recommendation. This collaborative approach ensures that treatment plans reflect input from every relevant specialty.

For patients traveling to Boston for treatment, BWH provides coordination assistance including lodging recommendations, transportation options, and connections to support services. Several organizations offer free or reduced-cost housing near Boston hospitals for cancer patients and their caregivers, and BWH's social work team helps connect patients with these resources.

Insurance coordination is handled by BWH's financial counseling team, which works with patients before treatment begins to verify coverage, obtain prior authorizations, and identify financial assistance programs for any uncovered costs. Most major insurance plans cover mesothelioma treatment at BWH, including Medicare and many managed care plans.[1]

Why Does Massachusetts Have Significant Mesothelioma Incidence?

Massachusetts ranks among the top states for mesothelioma incidence due to its extensive history of shipbuilding, industrial manufacturing, and construction activity involving asbestos. The Boston Naval Shipyard (Charlestown Navy Yard) employed over 50,000 workers during peak production, with widespread asbestos use throughout ship construction and repair operations.

Beyond shipyards, Massachusetts industrial facilities including power plants, textile mills, paper mills, and manufacturing operations throughout the state used asbestos extensively in insulation, machinery components, and building materials. Workers in these industries and their family members who experienced secondary exposure contribute to the state's elevated mesothelioma rates.

The concentration of mesothelioma cases in Massachusetts contributed to the development of BWH's specialized program. The local patient population provided the clinical volume necessary to build surgical expertise, conduct research, and develop the multimodal treatment protocols that now attract patients from across the country. BWH's proximity to affected worker populations created the foundation for a world-class mesothelioma center.

"New England's industrial legacy created a concentrated mesothelioma patient population that drove the development of specialized treatment programs. Brigham and Women's Hospital responded to that need decades ago and has never stopped advancing the field."

— Dr. Elizabeth Baldini, Radiation Oncologist, Brigham and Women's Hospital

How Does BWH Compare to Other Top Mesothelioma Centers?

BWH stands alongside a small group of elite mesothelioma treatment centers including Memorial Sloan Kettering, MD Anderson, and Moffitt Cancer Center. What distinguishes BWH is its combination of surgical volume, research output, and the legacy of Dr. Sugarbaker's pioneering program — the longest-running dedicated mesothelioma surgery program in the world.

Surgical volume matters significantly in mesothelioma outcomes. Research consistently shows that patients treated at high-volume centers with experienced surgical teams achieve better survival than those treated at centers performing fewer mesothelioma surgeries annually. BWH's decades of accumulated surgical volume translate directly into better patient outcomes through refined technique and institutional expertise.[4]

Patients seeking the best possible mesothelioma care should consider consultation at multiple top treatment centers to compare recommendations. Second opinions are standard practice in mesothelioma care, and BWH actively welcomes patients seeking confirmation of treatment plans developed elsewhere. Many patients ultimately choose BWH based on the depth of its surgical experience and research capabilities.

Frequently Asked Questions About Brigham and Women's Hospital Mesothelioma Program

Q: What mesothelioma surgeries does Brigham and Women's Hospital perform?

Brigham and Women's Hospital performs both extrapleural pneumonectomy (EPP) and pleurectomy/decortication (P/D) for pleural mesothelioma, along with cytoreductive surgery with HIPEC for peritoneal mesothelioma. The surgical approach is individually tailored based on disease stage, cell type, and overall patient health following comprehensive evaluation.

Q: What are the survival rates at Brigham and Women's Hospital for mesothelioma?

Published data from BWH's International Mesothelioma Program shows 5-year survival rates reaching 46-51% for selected patients with epithelioid cell type who undergo multimodal treatment combining surgery, chemotherapy, and radiation therapy. These outcomes significantly exceed the national median survival of 12-18 months.

Q: How do I get referred to Brigham and Women's Hospital for mesothelioma treatment?

Patients can request a referral through their oncologist, contact BWH's International Mesothelioma Program directly by phone, or submit a new patient intake form through the hospital's website. BWH accepts patients from across the United States and internationally, and their coordination team manages the referral process.

Q: Does Brigham and Women's Hospital offer mesothelioma clinical trials?

Yes. BWH maintains an active mesothelioma clinical trials program offering experimental treatments including immunotherapy combinations, targeted therapies, and novel surgical approaches. As a Harvard Medical School teaching hospital with NCI-designated cancer center status, BWH often has first access to emerging treatments before they become widely available.

Q: Does insurance cover mesothelioma treatment at Brigham and Women's Hospital?

Most major insurance plans cover mesothelioma treatment at BWH, including Medicare and many Medicaid programs. The hospital's financial counseling team helps patients navigate coverage verification, prior authorizations, and financial assistance programs for any uncovered costs before treatment begins.

Q: What is the International Mesothelioma Program at Brigham and Women's Hospital?

The International Mesothelioma Program (IMP) is a dedicated multidisciplinary program at BWH focused exclusively on mesothelioma research and treatment. Founded by the pioneering thoracic surgeon Dr. David Sugarbaker, it brings together surgeons, oncologists, radiation specialists, pathologists, and researchers in a coordinated approach that has treated thousands of mesothelioma patients over four decades.