Mesothelioma surgery may be an option for patients to remove tumors and relieve symptoms.
Table of Contents
- Mesothelioma Surgery is often combined with chemotherapy and radiation.
- There are three types of Mesothelioma surgery, including diagnostic, potentially curative, and palliative.
- Potentially curative surgeries are usually reserved for patients in good general health.
- Palliative surgery can relieve symptoms and ensure the patient’s quality of life.
Mesothelioma patients have several surgical options available, including procedures to determine staging, remove tumors, or improve quality of life. When combined with chemotherapy and radiation, mesothelioma surgery can help improve patient outcomes for those with early stages of cancer. For patients with more advanced mesothelioma, the cancer has likely spread far enough away that surgery for a cure is no longer a viable option.
What Types Of Mesothelioma Surgery Are Available
There are three main types of surgical treatments available to patients, including diagnostic, potentially curative, and palliative care. Diagnostic surgery, which includes different types of biopsies, may be necessary to diagnose malignant mesothelioma. Once the cancer is confirmed, a mesothelioma specialist will develop the patient’s treatment plan. Depending on the type and stage of mesothelioma, other surgical options may be recommended.
After other diagnostic tests have been performed, including X-rays and CT scans, a biopsy will be performed to examine a sample of tissue or fluid and confirm the diagnosis of mesothelioma. When trying to diagnose pleural mesothelioma or pericardial mesothelioma, a thoracic surgeon will examine the heart and lungs for cancer.
Diagnostic Surgeries For Pleural And Pericardial Mesothelioma
This involves making a large incision between the ribs in the chest to remove large samples of tumor and fluid buildup.
During a thoracoscopy, a thoracic surgeon will make one or more small incisions between the ribs and then use a video camera to examine the patient’s chest wall and lungs. The doctor may also take tissue samples for further analysis.
An incision is made in the neck above the sternum (sternum) to insert a camera. The camera is used to investigate the area between the lungs known as the mediastinum.
Because peritoneal mesothelioma develops within the abdomen, mesothelioma surgeons can perform several unique procedures to take tumor samples and diagnose the disease.
Diagnostic Surgery For Peritoneal Mesothelioma
A laparoscope is a camera used to look inside the abdomen and check for tumors in the lining of the peritoneal tissue. Biopsies may also be taken during the process.
This procedure involves a larger incision than a laparoscopy and is usually used when doctors need a large sample of tumor to perform a biopsy. Sometimes a surgeon may try to remove the entire tumor during this process.
Usually reserved for patients in good health, curative surgeries aim to remove as much of the cancer as possible. Those who undergo these surgeries combined with chemotherapy and radiation as part of multimodal treatment often see higher survival rates. For example, cytoreduction and hyperthermic intraperitoneal chemotherapy (HIPEC) offer patients with peritoneal mesothelioma a 5-year survival rate greater than 50%. Curative surgeries include:
Potentially Curative Mesothelioma Surgeries
Extra Pleural Pneumonectomy (PPE)
An EPP is a surgery for patients with pleural mesothelioma in which the entire lung and the lining of the lung, and sometimes part of the diaphragm and pericardium (the sac around the heart) is removed. The procedure is usually reserved for patients with early-stage cancer who are in good health.
Pleurectomy / Decortication (P/D)
P/D is a surgery for patients with pleural mesothelioma in which the lining of the lung and sometimes part of the diaphragm is removed. The lung itself is left in place during this operation.
Cytoreduction and HIPEC
For patients with peritoneal mesothelioma, cytoreduction and HIPEC may be an option to address tumor growth. The two-step surgery begins by removing as much of the cancer as possible, then circulates a warm chemotherapy wash throughout the abdominal cavity to remove any remaining cancer cells.
A surgery for pericardial mesothelioma, this process involves removing some or all of the membrane surrounding the heart. This is meant to get rid of tumors and relieve pressure, improving heart function.
Palliative surgeries are sometimes performed along with potentially curative ones, but are generally aimed at relieving symptoms and can improve the patient’s overall quality of life in the final stages of the disease.
Some examples of palliative care surgeries include procedures that remove fluid around organs, such as:
- Pericardiocentesis: Used to treat pericardial effusion
- Pleurodesis: Used to treat pleural effusion
- Paracentesis: used to treat abdominal ascites
- Thoracentesis: Used to treat pleural effusion
These palliative care options may also be performed during the diagnostic process to collect fluid samples and help doctors determine if mesothelioma is present.
Side Effects And Recovery After Mesothelioma Surgery
Mesothelioma surgery, like any other surgical procedure, carries a certain amount of risk and complications can develop. Often, it is related to the aggressiveness of the procedure. Those in better general health may experience fewer side effects, but most patients will have some degree of pain, swelling, and bruising after their procedure that will eventually resolve.
Common Complications Of Mesothelioma Surgery
- Cardiac complications
- Low blood pressure
- Loss of appetite
- Falling asleep
In rarer cases, patients may experience bleeding, blood clots, respiratory failure, or heart attacks. In addition to watching for these side effects, when caring for a surgical wound, patients should look for signs of infection or other problems affecting the area. Symptoms may include increased redness, swelling or additional bleeding, pus, or sustained fever.
Patients should discuss any side effects they are experiencing with their medical team, who may recommend lifestyle and diet changes or additional medications to combat symptoms. Mesothelioma patients and their loved ones can also find help through online or in-person support groups.