Despite medical advances, mesothelioma remains an incurable cancer with limited treatment options. In mesothelioma, poor performance status is associated with worse survival and also excludes many patients from aggressive therapy. Poor performance status, or immobility, is often attributable to symptoms such as breathlessness, pain, fatigue and muscle wasting. Even amongst mesothelioma patients early in their diagnosis with good performance status, low muscle mass is common and negatively impacts participation in daily physical activity. Appropriately prescribed exercise provides a significant opportunity to counteract this aetiology of poor outcomes, although the specific challenges to exercise might differ from other cancer groups. Patients with mesothelioma have longer median survival and typically more localised disease than those with other advanced lung cancers, which has implications for the most appropriate type of exercise training for this population. Our recent research suggests that patients with mesothelioma can undertake progressive resistance exercise training safely and gain significant improvements in functional capacity, muscular strength, and muscle mass. This presentation will offer perspective on the potential for exercise as medicine for patients with mesothelioma.