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Treating Mesothelioma – Surgery - Mesothelioma Biopsy
Mesothelioma Biopsy and Treatment: What to Expect
Mesothelioma is a cancer affecting our mesothelial cells. These are the cells that cover the surface of the majority of our internal organs. Mesothelioma cancer is found to develop in:
- The pleura or the tissue lining/ covering the lungs and is therefore called Pleural Mesothelioma
- The peritoneum or the tissue lining the abdomen, thus the name Peritoneal Mesothelioma
Between these two types of mesothelioma, studies show that there are more cases of pleural mesothelioma than that of peritoneal mesothelioma.
Getting a Diagnosis
When patients are suspected to be suffering from mesothelioma, a diagnostic procedure called mesothelioma biopsy is performed to confirm diagnosis. There are multiple ways to get a diagnosis:
- The sample of a cancerous mass is obtained
- The fluid surrounding the mesothelioma lung is removed and then examined
- Samples of tissue specimens are taken from the mesothelioma lung.
Because fluid diagnosis can be ambiguous, it is sometimes insufficient to verify if the cell type is sarcomatous, epithelial or mixed. Diagnostic surgery then becomes necessary to obtain a confirmatory diagnosis.
Diagnostic Surgery
Video-assisted thoracic surgery or VATS allows the physician to examine the patient’s pleural space with the use of a camera. At the same time, the physician can extract the necessary amount of specimen samples to be analyzed by the pathologist. The procedure requires small incisions to be made and its invasive nature is often a cause of concern for increase in tumor seeding.
Thorascopy is less invasive but is only done when the pleural space has not been destroyed by the tumor. A therapeutic procedure to relieve fluid accumulation can be done simultaneously with thorascopy.
Another procedure, laparoscopy, is performed on patients after video images show that the tumor has possible forayed through the diaphragm.
The peritoneal biopsy procedure requires the surgeon to make a cut through the abdomen. A peritoneoscope is then inserted through the abdominal cavity. Images are then viewed by the surgeon through a video screen and samples are extracted for the pathologist to examine.
When the final diagnosis is positive mesothelioma, the patient will then undergo treatment.
Surgical Treatment - Potentially Curative Procedure
This type of procedure is done with the intent to get rid of all gross disease. However, since microscopic disease will likely stay behind; adjuvant therapy will also be performed. This is an additional treatment to the main therapy and is performed to remove any remaining disease.
- Pleurectomy/ Decortication – Usually administered to patients in the early stages of pleural mesothelioma. When the lung has to be removed to eliminate all traces of tumor, it can be done simultaneously through the pneumonectomy procedure.
- Extrapleural Pneumonectomy – This procedure for pleural mesothelioma patients is considered more radical and statistics show that it wasn’t successful in prolonging a life longer or achieving a cure. This surgical treatment is usually integrated with radiation therapy, chemotherapy, photodynamic, gene or immunotherapy.
- Cytoreductive Surgery – The procedure is done with the intent to eliminate majority, if not all gross tumor found in the peritoneal cavity of peritoneal mesothelioma patients. Intra-Peritoneal Hyperthermic Chemotherapy or IPHC is then administered to the abdominal cavity to remove all traces of tumor.
Palliative Surgical Procedure
This type of procedure does not target the disease itself but is only intended for the treatment of a mesothelioma symptom.
Chest Tube Drainage and Pleurodesis – Pleural effusion or fluid build-up is the initial symptom that makes a patient seek medical attention and this procedure is then administered. Considered the most common palliative treatment, it involves fluid drainage and the closing the pleural space to eliminate the problem.
Pleuroperitoneal Shunt – This procedure only involves placing a catheter under the patient’s skin, connecting the peritoneal cavity to the pleural cavity.
Pleurectomy – When an extensive surgery is not possible for a patient to undergo, then this procedure is the next option. However, gross or visible tumor will not be removed completely. Its controls pleural effusion effectively when there is restricted lung expansion because of the cancer.
- Cancer Research UK, CancerHelp.org.uk - "What is mesothelioma?"
- The David Law Firm, Mesothelioma Web - "Treatment Options - Surgery"
- SEO Systems Development, Mesothelioma Cancer Portal - "Mesothelioma Biopsy"