Primary prevention

Elimination of asbestos exposure through substitution with other materials will significantly decrease the risk of developing asbestosis and pleural-related changes, including malignant pleural mesothelioma. Legislation regarding asbestos elimination from the workplace is in place in many countries, and in the US (where regulations were implemented in 1972) it may partially account for the flat or slightly declining incidence of mesothelioma.

Minimization of exposure through engineering controls (i.e., enclosing work process or exhaust hoods) is the next best approach, after substitution, to reducing the risk of disease. Respirators with high protection factors (i.e., positive pressure or full face mask) are used for work where the location and conditions vary, such as construction. Provision to ensure that asbestos is not tracked home, such as laundering work clothes at work and lockers for clean (street) and dirty (work) clothes separated by a shower, are required to reduce asbestos exposure to workers' family members.

There is a need for research in the chemoprevention of asbestos exposure.[31]

The US Preventive Services Task Force (USPSTF) recommends against using beta carotene (precursor to vitamin A, retinol) or vitamin E supplements to prevent cancer.[32] A potentially increased risk for lung cancer has been reported with the use of beta carotene by persons who smoke tobacco or have occupational exposure to asbestos.[33]​[34]​

Secondary prevention

Smoking cessation should be encouraged to limit further deterioration in lung function. Immunizations to prevent pulmonary infections, such as influenza, are appropriate.

American Society of Clinical Oncology guidelines recommend:[101][102]

  • regular aerobic and resistance exercise during active treatment with curative intent to mitigate the adverse effects of cancer treatment

  • preoperative exercise to reduce hospital stays and postoperative complications

  • low-dose olanzapine to improve appetite and weight gain in patients with cancer cachexia, including chemotherapy-related anorexia, followed by either a progesterone analog or a corticosteroid if olanzapine is not tolerated.

Monitor patients for the development of depression and anxiety, and offer treatment as appropriate. Various nondrug treatment options can be offered, including mindfulness-based interventions, yoga, relaxation, music therapy, reflexology, and aromatherapy.[103]

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