What is Mesothelioma Surgery?
When an individual is diagnosed with mesothelioma cancer, treatment options will be among the first topics discussed with oncologists. The available mesothelioma treatment options will vary from patient to patient depending on the type of cancer that has been diagnosed and the coordinating stage that the disease has progressed to. In particular, Mesothelioma cancer is an extremely deadly and aggressive medical condition, for which treatment options are quite limited.
The problem with treatment regarding mesothelioma is tied into the fact that mesothelioma cancer is nearly impossible to detect. During its early stages, the condition reveals no conspicuous symptoms. Frequently, a mesothelioma sufferer will not feel sick or notice symptoms until decades following the initial contraction. When finally diagnosed, the disease has often morphed into its latter stages. At this point, all associated treatment options are only palliative in nature—there is no cure for stage III or stage IV mesothelioma.
If, by chance, mesothelioma is caught in its early stages, a patient will be presented with a number of options for treatment, including curative measures, such as surgery. There are several forms of mesothelioma surgery; some are curative and some will only relieve symptoms to improve the patient’s quality of life.
Curative Mesothelioma Surgeries:
Due to the nature of mesothelioma cancer and the fact that by the time a diagnosis is rendered the disease has typically reached an advanced stage, a surgical cure is rarely an option. However, in rare cases, surgery is recommended to remove as much of the cancer as possible. After the cancer is removed, the patient must endure subsequent mesothelioma treatments, such as radiation or chemotherapy.
In ideal situations, candidates for mesothelioma surgery will be in the early stages of the cancer where the tumor is localized and metastasis has yet to take place. Additionally, to effectively perform mesothelioma surgery, the patient must be in good overall health and free of other medical issues that complicate the procedure and impede the recovery period. Simultaneous medical conditions, such as hypertension or diabetes, are often issues with elderly mesothelioma patients, further complicating treatment options and making aggressive procedures—like surgery—unenviable solutions.
That being said, if the doctor determines the patient is strong enough, the following mesothelioma surgeries may be performed (Note: these surgeries will only be performed for patients of early-stage of mesothelioma):
Mesothelioma Surgery: Pneumonectomy
A Pneumonectomy is an ambitious surgery that involves the extraction of the infected lung. Candidates for Pneumonectomy must have mesothelioma cancer that is only limited to one of their lungs. Performed under traditional anesthesia, Pneumonectomy is a radical and complicated mesothelioma surgery that can last up to four hours. During a Pneumonectomy the diseased lung is deflated and after several hours to prevent bleeding into the chest cavity, the lung is extracted through a wide incision. A drainage tube must then be inserted for the incision to be closed. The patient must remain in intensive care for at least 48 hours and then in a regular hospital unit for one to two weeks. Because of the extreme nature of Pneumonectomy, approximately 50% of patients who undergo this mesothelioma surgery will experience complications. Moreover, it may take up to six months for the health lung to recuperate and effectively expedite the breathing process.
Mesothelioma Surgery: Extrapleural Pneumonectomy
Extrapleural Pneumonectomy surgery is only recommended in rare cases. This mesothelioma surgery involves the removal of the affected lung and the surrounding areas.
Extrapleural Pneumonectomy is a very risky operation and carries with it a laundry list of complications including: serious gastrointestinal problems and heart failure. This form of mesothelioma surgery is similar to a Pneumonectomy and prospective candidates are those individuals who are diagnosed with early stage mesothelioma. To receive Extrapleural Pneumonectomy, the mesothelioma cancer must be localized; it cannot spread to the lymph nodes. Additionally, candidates must be in strong physical health. The recovery period associated with Extrapleural Pneumonectomy can last for up to a half-year or longer.
Mesothelioma Surgery: Pleurectomy
This type of mesothelioma surgery involves the removal of the parietal pleura (lining of the lungs) and the visceral. A Pleurectomy may be performed as a curative procedure; however, the operation is commonly undertaken to subside pleural effusions—the build-up of fluid in the lungs.
A Pleurectomy is performed under general anesthesia. The surgery commences with an incision in the affected area. Through this incision, both the outer and inner lungs are extracted. The surgeon may also choose to remove the lung tissue located beneath the pleura.
Following a Pleurectomy operation, chemo or radiation will be administered to remove any remaining cancerous tissue. Post-surgery stay for Pleurectomy will typically last a week or longer if complications arise following the surgery. Traditional complications include: infection and/or bleeding.
Mesothelioma Surgery: Palliative Surgeries
These surgeries, which are common among mesothelioma patients, are administered to mitigate the symptoms of the cancer. Palliative surgeries are not meant to cure the disease.
Palliative surgeries relieve pain and other problems associated with mesothelioma cancers. These surgeries will not affect the prognosis of the disease; patients who undergo a palliative surgery are still likely to die from mesothelioma cancer within 6 months to 1 year. This pessimistic outlook is largely due to the fact that palliative surgeries are only performed with patients who are diagnosed with stage III or stage IV mesothelioma.
Palliative Surgeries: Pleurocentesis
Pleurocentesis is utilized to address pleural effusion—build-up of fluids in the pleural region surrounding the lungs. This fluid often makes it very difficult and painful for a mesothelioma suffered to breathe. A Pleurocentesis is performed in an outpatient location by means of an extended needle that is inserted into the pleural region. The needle is used to extract the fluids. The patient may return home just a few hours after the surgery.
Palliative Surgeries: Paracentesis
Paracentesis is, in essence, the same operation as a pleurocentesis operation. A paracentesis is undertaken to remove fluid that builds in the abdominal area; the goal of this palliative mesothelioma surgery is to provide more comfort to patients with severe symptoms.
Palliative Surgeries: Pleurodesis
This is the most extreme palliative surgery associated with mesothelioma treatment. Pleurodesis is utilized to stop the build-up of fluid for an extended period of time. Doctors performing this mesothelioma surgery will insert talc into the pleural space. The talc causes inflammation and halts the fluid from amassing for as long as 5 years. Pleurodesis is an inpatient surgery performed under general anesthetic. This operation requires a hospital stay of at least 3 days, during which a chest tube may remain in the patient to drain any excess fluids. Recovery time is approximately 6 to 8 weeks for the majority of patients.