Mesothelioma Treatment Information:
Surgery
There are several types of surgeries that may be available for mesothelioma. The disease type, stage and the individual’s age and condition will determine if and what type of surgery may be performed. Because mesothelioma is a diffuse malignancy, where tumors are spread throughout the mesothelial tissue making complete extraction of the cancerous tissue impossible, surgery is usually combined with chemotherapy and/or radiation therapy to ensure the best results.
There are generally two types of surgical methods for the treatment of mesothelioma:
Surgical Methods for the Treatment of Mesothelioma: Palliative Procedures
Palliative Procedures are those procedures that treat the symptoms of mesothelioma, providing relief for the patient, without aggressively treating the disease itself. These procedures include:
- Chest Tube Drainage and Pleurodesis
- The goal of chemical pleurodesis is to cause an irritation between the two layers covering the lung. This irritation causes an obliteration of the space between the layers where the fluid accumulated, and prevents further fluid to be able to accumulate there. A variety of agents can be used for this, including talc and bleomycin. As the pleural space is closed,fluid drains out of the chest cavity using a chest tube.
- Pleuroperitoneal Shunt
- Pleuroperitoneal shunting has been used in patients who have failed chemical pleurodesis, chemotherapy, or radiation therapy. Pleuroperitoneal shunting can provide effective palliation in patients with a trapped lung or others who have failed treatment.
Surgical Methods for the Treatment of Mesothelioma:
Life-Extending Procedures
Life-Extending Procedures for the treatment of mesothelioma attempt to arrest progression of the disease by removing as much of its physical presence as possible. Residual disease cells that were not removed, either because they were not visible to the eye or had infected a part of the body where surgery was not possible, are then treated with adjuvant therapy.
As we've noted elsewhere, mesothelioma has no cure, so the following procedures are not considered to be curative procedures. They are, however, often effective at extending a patient's life longer than if he or she refused or was not a candidate for these treatments.
These procedures include:
- Pleurectomy/Decortication
- A Pleurectomy/Decortication is a surgical procedure where the pleura, the membrane lining the lungs and chest cavity, is removed, without removing the entire lung. This treatment option is usually performed on patients in an early stage of mesothelioma.
- Extra-Pleural Pneumonectomy (EPP)
- EPP is the removal of the pleura, diaphragm, pericardium, and the whole lung involved with the tumor. As EPP is considered a radical therapy and is not frequently performed by most surgeons, patients are referred to centers specializing in these treatments.
- Multi-modal Therapy
- Both the above “potentially curative” procedures are typically used in combination with other treatment options (multi-modal therapy).