For years a jobbing carpenter, and more recently a very successful builder, Geoff was ready, with his wife, Bernadette, to ease back and enjoy his retirement. He was 50. But one day at work, while supporting a small steel beam on his shoulder, he ran out of breath, just standing there. That was in September 2002 and, following a bewildering variety of tests at the Wythenshawe hospital, Manchester, the formal diagnosis was delivered in February 2003.

Mesothelioma is a cancer of the pleura, the silky-thin lining of the chest. The disease transforms it into a hard, rubbery substance around the lungs, gradually restricting their function. Breathlessness progresses to extreme pain and respiratory collapse. Time from diagnosis to death is rarely more than a year. There is little we can do, said the specialist, except offer palliative care. But to Bernadette, doing nothing was unthinkable. Well, the specialist said, the UK's first chemotherapy trial for mesothelioma, called MS01, was running. A computer would randomly pick Geoff's treatment: one chemotherapy drug, a new cocktail of three, or just symptom and pain control.

But Bernadette had another possibility in mind: while finding out all she could about mesothelioma on the internet, she'd located one of several American surgeons who remove the lung, plus the pleura and part of the diaphragm, albeit for an impossible $250,000. So what about radical surgery here? The quality of life is so poor afterwards, it's not worth it, said the specialist. And 40% don't survive the operation. But that, as Bernadette knew from her web-surfing, was wrong, old information.

She wanted Geoff to see David Waller at Glenfield hospital in Leicester, one of just 10 UK surgeons who perform the radical option. Wythenshawe responded as if the couple were mad to consider it. But she got her appointment. Waller was blunt: I can't cure you, but some of my patients are alive four years after surgery.

After Geoff had the operation it was back to Manchester, to yet another hospital, Christie's, for mopping-up radiotherapy. But Christie's said, if they were reading Glenfield's pathology report right, the cancer had spread and they couldn't justify radiotherapy: enough damage had already been done. It was a bash in the face. Perhaps the truth was Christie's admitting: "We have no experience of treating people like you."

So, off to hospital number four: Cookridge in Leeds, which specialises in this type of tricky postoperative radiotherapy. And Cookridge said Geoff's cancer had not spread, after all. The couple had to drive from Manchester to Leeds and back, three hours' travelling a day, for 25 sessions.

Asbestos dust is the only known cause of mesothelioma. Geoff's near-fatal exposure came from sawing asbestos roof soffits in the 1970s. Today, with his one good lung and a new Gore-Tex diaphragm, he looks fine, and he feels he's been given the best chance. Still scared and angry, Bernadette says: "There seems to be a breakdown in communication between these hospitals."

The bad old days of maximum asbestos production and its ubiquitous use are gone. But that's not true of asbestos diseases. There is a rising epidemic in every country that once mined it or made asbestos products. Russia, China, Zimbabwe are still hard at it; unbelievably, Canada mines and exports white asbestos to the Third World.

In Britain, asbestosis, the first disease identified, is dying out. But mesothelioma? Specialists are blunt: it's a national disaster. There has been a threefold increase in it since 1990. It now kills 1,800 people a year — nearly twice the number that die from cervical cancer, but with no equivalent of the latter's comparatively funding-rich screening programme. Asbestos-triggered lung cancer claims up to twice that many. Worse is to come. Given that these cancers take up to 60 years to appear, the epidemic won't peak until 2015, when up to 6,200 deaths will occur.

The epidemic will not subside until 2050. And that's assuming nobody has any further exposure to asbestos dust. But hundreds of thousands of British homes have asbestos in their fabric, and builders, DIY enthusiasts and maintenance workers aren't always aware of it — so it's a vain hope. Unlike asbestosis, usually the result of breathing quantities of asbestos dust over time, these cancers can be seeded by relatively brief exposures. As the World Trade Organization stated in 2001, there is no safe level of exposure, and "controlled risk" is "unachievable". Even on the rosiest predictions, up to 185,000 more deaths are expected here by 2050, another quarter of a million across western Europe and a third of a million in North America. In developing nations, the toll will be colossal.

So what are we doing about it? Not much. The UK's plight takes the breath away in more ways than one. Asbestos is the leading cause of work-related cancer, is the most fatal manufactured carcinogen after tobacco, and accounts for more deaths each year than road accidents (3,450 people died on UK roads in 2001). Yet no government funds have been allocated, that is,"ring-fenced", for tackling the epidemic. Nor is there anything resembling a national medical strategy. Centres of treatment excellence are emerging in London, Leicester, Newcastle and Glasgow, but in between, as Geoff and Bernadette discovered, is a shambles.

There is little hope for cases of asbestos-triggered lung cancer. Closely resembling the smoking-induced variety, it's just as intractable, and no existing treatment has any great impact. But the prognosis for mesothelioma is very different. "There's no good reason why it shouldn't become a chronic, manageable disease," says Dr Kenneth O'Byrne, former head of the British Mesothelioma Interest Group. "And because of how mesothelioma grows and spreads, it's also reasonable to anticipate a cure for some patients."

For the most advanced medical model, look Down Under. Galvanised by the highest asbestos-mortality rate in the world, Australia has a slew of medical world firsts, including emergent preventive treatments and immune therapies. All could be used here. "So we'd not be looking for huge government monies," said O'Byrne.