When we began working alongside Dr. David Sugarbaker and the International Mesothelioma Program (IMP) in Boston over two decades ago, there was a phrase we heard repeatedly:
Multimodal therapy.
At the time, it was more than just a treatment strategy — it represented a completely different way of thinking about mesothelioma.
The philosophy was simple but groundbreaking: no single treatment could successfully manage this complex disease. Instead, the best outcomes would come from combining the expertise of many specialists and using every appropriate treatment available.
Back then, however, “every treatment available” looked very different than it does today.
Patients had one FDA-approved chemotherapy regimen. Immunotherapy did not exist. Molecular profiling was in its infancy. Clinical trials were fewer, surgical techniques continued to evolve, and physicians were often making difficult decisions with far fewer options than they have today.
What stood out most wasn’t just the treatments — it was the collaboration.
Thoracic surgeons, medical oncologists, radiation oncologists, pulmonologists, pathologists, radiologists, nurses, and supportive care teams came together to discuss each patient individually. There wasn’t one physician making decisions in isolation. Every case was evaluated from multiple perspectives with one shared goal: determining the best treatment plan for that particular patient.
As nurses working with mesothelioma patients and their families, we witnessed these discussions firsthand. We also saw how reassuring it was for families to know that an entire team, not just one specialist, was involved in their care.
Fast forward to 2026, and the treatment landscape has changed dramatically.
Today, patients may benefit from immunotherapy, more refined surgical techniques, precision radiation therapy, molecular testing, clinical trials, improved supportive care, and an expanding list of treatment options that simply weren’t available when the IMP was pioneering multidisciplinary care.
Yet despite all these advances, one thing has remained remarkably consistent.
The recently published 2026 Society of Thoracic Surgeons Expert Consensus on the Multimodal Treatment of Pleural Mesothelioma, led by Dr. Jeffrey Velotta and an international panel of mesothelioma experts, reinforces the very same philosophy that guided the pioneers of mesothelioma care years ago.
The consensus does not suggest that one treatment is superior to another.
Instead, it emphasizes that patients should be evaluated by an experienced multidisciplinary team at a high-volume mesothelioma center, where specialists work together to determine the most appropriate combination of treatments for each individual patient.
That team includes thoracic surgeons, medical oncologists, radiation oncologists, pulmonologists, radiologists, pathologists, specialized nurses, rehabilitation professionals, palliative care experts, and supportive services for both patients and families.
This collaboration is not simply beneficial — it is considered the standard of care.
The consensus also reinforces another important point that can sometimes be misunderstood:
Surgery is not the treatment. It is one component of treatment for carefully selected patients.
Whether surgery is appropriate depends on many factors, including the patient’s overall health, disease stage, tumor characteristics, and goals of care. Those decisions are best made collectively by clinicians who treat mesothelioma every day.
Perhaps that is what makes this consensus so significant.
In a field that has changed dramatically with new therapies, new technology, and new research, the world’s leading mesothelioma specialists continue to agree on the principle that mattered twenty years ago:
The best treatment decisions are made together.
For patients and families facing a mesothelioma diagnosis, that may be the most important message of all.
Medicine will continue to evolve, and new therapies will undoubtedly emerge. But one recommendation has stood the test of time:
Seek care at an experienced, high-volume mesothelioma center where specialists collaborate to develop an individualized treatment plan.
The treatment options have changed.
The commitment to multidisciplinary care has not.
And after more than two decades, that remains one of the strongest messages in mesothelioma care.
Author: David Foster
Over the last 15 years, David has worked with the Dandell team to build a group of professionals whose goal is to make clients feel like their voices matter and that they are part of a family.
Reviewed by: Devan El Dana, PharmD
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