Improving Survival Through Mesothelioma Surgery
When patients are diagnosed with mesothelioma, they require a specialized multimodality treatment plan, which may include surgery. Mesothelioma surgery can help extend a patient’s life and reduce painful symptoms.
Video Summary: Registered Nurse Amy Fair discusses mesothelioma surgery options and who may be a candidate. View Transcript.
What are the surgical treatment options for mesothelioma?
It’s important to talk to your surgeon and oncologist to see if you are a surgical candidate. Some folks that have extensive disease (cancer) are not a surgical candidate and they will start with other treatment modalities such as radiation and chemotherapy. With comorbidities such as diabetes, heart, and some lung conditions the surgeon may tell you you’re not a surgical candidate. Sometimes the cell type of your disease and the staging also drives if you are a surgical candidate or not for surgery.
Some of the surgeries performed for mesothelioma are a decortication, which is where they remove the lining of the lung, sometimes called a pleurectomy. There is a more extensive surgery called a pneumonectomy. That is where they remove the whole lung. There are surgical interventions for the peritoneal mesothelioma. Sometimes they will go in and do a recession of the damaged or diseased part of the intestines. There is a procedure called a HIPEC procedure where they go into the abdomen and they flood the abdomen with what is called a chemo wash. It is a more direct line and source of chemotherapy than the intravenous route.
Your surgeon will explain to you all the components of the surgery, pre-surgery, and post-surgery. They will tell you that you may have a chest tube. Many times, surgeries, decortications, things like that will cause the lung to collapse. That’s very normal so they will tell you that you may have a chest tube in place to inflate or to keep that lung from collapsing. Post-surgery it’s all about the healing phase. It’s about pain control. It’s about getting up and keeping your pneumonias down, getting up and being active. Post-surgery sometimes the patient is sent home with a catheter in their pleura called a pleura evac, pleura catheter where it continues to drain the fluid once the patient is at home. They will talk with them about good nutrition. They will talk with them about keeping their immune system strong so the healing process proceeded like it should.
During mesothelioma surgery, doctors remove the mesothelioma as best as possible, either fully or partially.
Your doctor will perform specific surgeries depending on your disease:
- Cell type
Surgeries can be risky, especially if the cancer has spread. Your doctor will help you determine if you are eligible for surgery, however, all patients are advised to seek a second opinion from a mesothelioma specialist before undergoing surgical treatment of any kind.
Mesothelioma Treatment Goals
A doctor may recommend surgical intervention to accomplish specific mesothelioma treatment goals.
Treatment goals may include:
- Eliminating mesothelioma completely from the chest, abdomen, or heart
- Removing as much of the visible tumors as possible
- Preventing recurrence (when cancer comes back after treatment)
- Improving the quality of life by relieving pressure from the chest, abdomen, or heart
It’s critical for patients to have a good understanding of the goals of each type of surgery so that they can play an active role in their own health decisions.
Who Is Eligible for Mesothelioma Surgery?
Not every patient will be eligible to undergo mesothelioma surgery.
Patients who have the following may not be eligible for mesothelioma surgery:
- Advanced age
- General poor health
- Other serious medical conditions (comorbidities)
- Smokers or former smokers
- Heavy drinkers
Provided they meet the right criteria, many patients will be recommended mesothelioma surgery. Surgery-based multimodal treatment typically gives patients the best shot at long-term survival.
Quick Facts About Mesothelioma Surgery
- Mesothelioma surgery can have serious risks and side effects, with roughly 1 in 3 patients having major complications during or after surgery.
- According to the American Cancer Society (ACS), a small number of people who have had curative mesothelioma surgery lived long periods of time without cancer.
- Some studies have suggested that mesothelioma surgery that removes a part of the lung is preferable to surgeries that remove an entire lung.