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Mesothelioma Treatment and Surgery
Mesothelioma is a form of cancer that may develop in people who have suffered from asbestos exposure. While mesothelioma is not as common as many other forms of cancer, it is deadly. The average lifespan of someone diagnosed with mesothelioma is 12 months. Mesothelioma is most common in the pleural cavity that surround the lungs, but it can also develop in the abdomen or in the membrane surrounding the heart. Mesothelioma is often a poor candidate for surgery because of the invasive nature of the tumors and the fact that the cancer is often in the later stages by the time a diagnosis is made.
Treating Mesothelioma With Surgery
A patient that is diagnosed with mesothelioma is likely to undergo surgery as part of the treatment for his disease. While surgery rarely offers a complete cure for mesothelioma, it can be used to remove tumors that have not spread, or to remove the pleura, which reduces the symptoms of the disease. When a patient has surgery as part of the treatment for mesothelioma it is termed curative surgery. Surgery that is used to reduce the symptoms of the disease, but does not offer any cure is termed palliative surgery.
Surgery as part of the treatment protocol for mesothelioma is normally coupled with either chemotherapy or radiation. The reason that surgery alone is not used is because even if the doctor believes that all the tumor has been removed, there is a chance that small seeds of the tumor remain. These seed cells are destroyed by chemotherapy or radiation.
Surgery used in conjunction with chemotherapy or radiation is an aggressive treatment protocol, but one that greatly increases the patient's chances of long term survival. For the patient to withstand this aggressive treatment, his health must be relatively good. The doctor will assess overall health before making a decision on treatment.
Surgery Used on the Mesothelioma Patient
Pleurectomy/decortication: This surgery is used for both curative and palliative reasons. Performed in the early stages of the disease it is possible for the doctor to remove the entire tumor. If the cancer has progressed into stage II or further, the surgery may still be used for palliative reasons. This surgery removes the pleura. This removal prevents the excessive build up of fluid which makes it easier for the patient to breath. Removal of the pleura also removes much of the pain associated with mesothelioma.
In some cases of pleurectomy/decortication it is necessary to remove the patient's lung that is affected by mesothelioma. In these cases the surgery is referred to as a pneumonectomy.
Extrapleural pneumonectomy: The term for an aggressive surgery used to treat mesothelioma. Very few doctors will perform this surgery, and the few that do insist that your health be excellent before agreeing to the surgery. The purpose of the extrapleural pneumonectomy is to cure the mesothelioma by removing all of the tumor and some surrounding tissue as well. This gives the patient the greatest chance that the mesothelioma will remain in remission.
In the extrapleural pneumonectomy, the surgeon removes the pleural lining around the chest wall as well as the diaphragm, the pericardium and the lung that is on the affected side. The surgeon then rebuilds the diaphragm and the pericardium with prosthetic material. This process is considered major surgery, and is only used on a small percentage of mesothelioma patients.
Thoracentesis: This procedure is used on patients that are in a great deal of pain due to pleural effusions. Pleural effusions, or the excess build up of fluid in the pleural cavity, are a common symptom of mesothelioma, and cause pain and a shortness of breath. During the thoracentesis procedure, the doctor drains the excessive fluid from the lungs with a needle. After the fluid is removed, the doctor may inject an irritant, such as talc, into the space. This irritant causes scar tissue to develop in the space between the pleura, which prevents the accumulation of fluid.
Cytoreductive Surgery: This is the term used for tumor removal in the abdominal cavity. Patients that have peritoneal mesothelioma undergo cytoreductive surgery as part of their treatment. The goal of this surgery is to remove as much of the primary tumor as possible. The surgery is followed up by chemotherapy or radiation.
The Benefits of Surgery
Although the tumors that develop from mesothelioma are difficult to remove surgically, surgery is still a valuable tool for the mesothelioma patient. The procedures listed above may give the mesothelioma patient added time with their family, or the ability to live life in a more pain free way. There are also continued advancements in the surgical treatment methods used by surgeons to treat mesothelioma. Because mesothelioma has such an unsatisfactory rate of cure, and so many patients die within months of diagnosis, physicians are always searching for a more effective treatment.
For information about other types of treatment, please see “Mesothelioma Treatment Overview.”
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