Mesothelioma TreatmentSurgery
Surgery is a possible option for those who are in the early stages of mesothelioma. At this time, the cancer is localized and has not yet spread into other organs or tissue in the body. Curative surgery aims to remove the cancer and any affected surrounding tissue, slowing the growth of the cancer. Palliative surgery is a viable option for pain relief because it attempts to drain accumulated fluids that cause difficulty and pain breathing.
Curative surgery attempts to rid the patient of mesothelioma tumors. This surgery is considered if the tumor has not spread and can possibly be removed entirely, but only if the patient is relatively healthy. A pleurectomy is a complicated surgery that removes only the affected lung. A more invasive curative surgery is an extrapleural pneumonectomy, which is the removal of the entire lung, part of the pericardium (the membrane covering the heart), part of the diaphragm, and a portion of the membrane lining the chest cavity (the parietal pleura). This procedure is far more risky than a pleurectomy, and typically a last resort, because it cuts the patients breathing capacity in half. This surgery is very complex and must be performed by a specialized surgeon.
Palliative surgery is also a possible option for mesothelioma. This type of surgery aims to treat the disease by relieving pain and suffering. This surgery is typically performed when the cancer has already reached later stages and has spread throughout the body. A painful symptom of mesothelioma is the accumulation of fluid in the chest cavity. A common treatment for this is thorecentesis, where a needle is inserted into the pleural space to drain the fluid. This procedure greatly relieves pain and eases breathing, but the frequent use of this treatment can cause the fluid to return more rapidly. A pleurodesis permanently blocks the fluid from returning by closing off the pleural space. A rare treatment to relieve pain is a pleurectomy, where the pleura is removed in order to prevent the painful fluid buildup and to remove cancerous tumors.
Surgery can also be performed on peritoneal mesothelioma. Curative surgery can remove tumors from the abdomen wall and other affected tissues and organs. Palliative surgery can ease the painful symptoms caused by these tumors. As with pleural mesothelioma, these tumors are often too large to remove completely.
Pneumonectomy
Generally, the options most often recommended for the treatment of malignant mesothelioma are chemotherapy and radiation. However, when surgery is a consideration, the procedure recommended for advanced meso patients is the pneumonectomy.
What is a Pneumonectomy?
An extrapleural pneumonectomy is a surgical procedure whereby the entire diseased lung, the pericardium, a portion of the diaphragm, and the parietal pleura is removed from the affected side of the chest cavity. This option is usually considered when the cancer is located in the center of the lung, encompassing both the veins and pulmonary artery as well.
Because of its complexity, the pneumonectomy is a last resort and is not widely performed. This means if your doctor recommends the procedure, you may have to travel away from your home to find the best doctor to perform the surgery.
What is the Success Rate?
If you are deemed a viable candidate for this surgery, you can expect to benefit greatly from this procedure. Doctors have determined that after a successful extrapleural pneumonectomy, followed by chemotherapy and/or radiation, a meso patients lifespan can increase from months to years.
Disadvantages
Because there will be only one remaining lung after surgery, patients who undergo pneumonectomy will obviously suffer from diminished lung capacity. That means the health of your remaining lung will largely determine whether or not you are a candidate for this surgery. If the other lung is diseased as well, breathing would be extremely difficult after the pneumonectomy.
After successful surgery, patients should remember to:
- Participate in any pulmonary rehab programs recommended by your doctor
- Avoid smoking
- Maintain a healthy weight
- Develop a sensible exercise program
