Mesothelioma Treatments: 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:

•  Palliative Procedures
•  Potentially Curative Procedures
  
  

Surgical Methods for the Treatment of Mesothelioma:
Palliative Procedures

Palliative Procedures are those which 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:
Potentially Curative Procedures

Potentially Curative Options are medical procedures that attempt to remove all gross disease with “curative intent.” Residual microscopic disease cells are then removed through Adjuvant therapy. 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 the early staging of mesothelioma.

Extra-Pleural Pneumonectomy (EPP)

EPP is the removal of the pleura, diaphragm, pericardium, and the whole lung involved with the tumor. EPP is considered a radical therapy and is not frequently performed by most surgeons, patients are referred to centers specializing in these treatments.