So I got diagnosed October 2025 after a persistent cough that wouldn't quit, had the surgery in December at UC San Diego. Before that I spent weeks trying to figure out where to go and what actually matters when you're picking a place. I want to lay out what I learned because a lot of the stuff online doesn't help much.
First thing: your surgeon matters more than the hospital name. I talked to three places, Brigham up in Boston, National Jewish in Denver, and UCSD. The surgeon at UCSD, Dr. Raymond Chen, sat down with me and my wife and walked through exactly what he was going to do, how many he'd done, what his outcomes looked like. Not a sales pitch, just facts. Brigham's guy was good too but the travel was gonna kill us and my VA claim was already a mess without adding that on top.
Second: ask them point blank which multimodal approach they'd actually use on you and why. Surgery, chemo, radiation, TTF, whatever. Don't let them dance around it. At UCSD they said pleurectomy plus cisplatin-pemetrexed and then we'd see about radiation. That's what happened. Some places wanted to throw everything at it immediately and that worried me because I'm stage II, not stage IV.
Third: find out if they work with the VA. This one killed me. My claim was filed in November and still sitting in November when I had surgery in December. But UCSD has a VA liaison and she helped push things through. That mattered because the VA's gonna cover most of it if you served at Camp Lejeune or on a ship with asbestos like I did on the Iwo Jima back in 1980.
Fourth: ask how many meso cases they do a year. UCSD does probably fifty, sixty a year. That's solid. Some hospitals do five or six and they're just gonna follow a protocol anyway.
And get a second opinion. I'm serious. Take your scans to another place, another surgeon. Mine said the same thing UCSD said so I felt better about the decision.
Recovery's been harder than I expected. Three months out now and I still get winded but the cough's gone which is something. The chemo was rough but we knew it would be.