Mesothelioma Surgery

Mesothelioma patients of any disease location and stage have important surgical options that can increase survival or improve quality of life. Mesothelioma surgeries are developed and performed by highly skilled surgeons specializing in mesothelioma. You may have a few surgery options, so working with an experienced mesothelioma doctor is critical in making the right choice for you.

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Mesothelioma Surgery Overview

If you’ve been diagnosed with mesothelioma, it’s critical to explore all your treatment options, including surgery. Mesothelioma surgery can help extend your life and reduce painful symptoms.

During mesothelioma surgery, doctors remove the mesothelioma either fully or partially.

Your doctor will perform specific surgeries depending on your disease:

  • Location
  • Cell type
  • Stage

Surgeries can be risky, especially if the cancer has spread. Your doctor will help you determine if you are eligible for surgery.

All patients should seek a second opinion from a mesothelioma specialist before undergoing surgical treatment of any kind.

Why Do I Need Mesothelioma Surgery?

When patients are diagnosed with mesothelioma, they require a multimodal treatment plan that may include surgery.

Mesothelioma surgery can help extend your lifespan and alleviate painful symptoms. It’s critical for patients to have a good understanding of the goals of each type of surgery so that patients can play an active role in their own health decisions.

A doctor may recommend surgical intervention to accomplish specific 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

There are different types of surgeries doctors use to accomplish these goals. The surgery chosen largely depends on the mesothelioma location and stage.

Surgery to Treat Mesothelioma

Though there is no cure for mesothelioma, surgery can remove all visible signs of cancer and help extend a patient’s life. Different surgical approaches have different objectives, and no two treatment plans are the same for mesothelioma patients.

During surgery, doctors cut open the patient and physically remove all visible tumors. They try to remove as much as possible, but sometimes there are cells remaining.

To prevent mesothelioma from growing again after surgery, doctors prescribe chemotherapy and/or radiation therapy to support the surgery and help eliminate leftover cells.

Surgery Improves Mesothelioma Life Expectancy

There is no cure for mesothelioma, but surgery can significantly improve life expectancy by removing all visible signs of cancer and preventing mesothelioma recurrence.

Palliative Surgery

Palliative surgeries relieve painful symptoms by draining fluid or removing diseased tissues and tumors. Some palliative surgeries are minimally invasive and involve inserting a small hollow needle into the chest or abdomen.

Palliative surgeries are common for most mesothelioma patients unless you’ve been diagnosed at a very advanced stage and you’re not healthy enough to undergo even limited surgery.

Though palliative surgeries are commonly associated with end-stage treatment, they can also be helpful for stage 1 and 2 patients awaiting surgery.

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Who Is Eligible for Mesothelioma Surgery?

Complications can arise during and after surgery, so only certain patients are eligible for procedures.

Doctors want to make sure their patients can withstand the stresses that surgery imposes on the body and that they can make solid recoveries.

Here are factors that determine eligibility for surgery:

  • Disease stage
  • Patient age
  • Overall health level of the patient
  • Whether the patient has other health conditions such as heart failure or emphysema

Provided you meet the right criteria, surgeons want to conduct surgeries on eligible patients, as surgery-based multimodal treatment gives patients the best shot at long-term survival.

Mesothelioma Surgery Options

The three mesothelioma locations — pleural, peritoneal and pericardial — are all considered different diseases.

As such, they each have their own standard treatments, including specially developed surgical procedures. Your doctor will perform specific surgeries depending on what type of mesothelioma you have.

Here’s what you need to know about the surgical options for each mesothelioma location:

Pleural Mesothelioma Surgeries

Pleural mesothelioma surgeries involve making a small or large incision in the chest cavity, depending on the technique being used. For pleural mesothelioma, there are two surgery options, both typically involve open surgery.

Doctors will perform either an extrapleural pneumonectomy (EPP) or pleurectomy with decortication (P/D) to treat pleural mesothelioma.

Extrapleural Pneumonectomy (EPP)

As the first surgical procedure developed for pleural mesothelioma, the extrapleural pneumonectomy (EPP) is a commonly performed procedure for stage 1 and 2 pleural mesothelioma patients. It can also be done on stage 3 and 4 patients in certain cases

During the EPP, the surgeon removes the affected lung, the pleura (lung lining), the pericardium (heart lining), part of the diaphragm, and nearby lymph nodes.

It’s an extensive procedure only conducted by highly skilled thoracic oncological surgeons. The EPP procedure, in conjunction with chemotherapy and/or radiation, can extend patient lives by several months.

Pleurectomy With Decortication (P/D)

The other surgery option developed for pleural mesothelioma is the pleurectomy with decortication (P/D).

Called a lung-saving surgery, the P/D allows the patient to keep their lung, but surgeons remove the diseased pleura (pleurectomy) and any surrounding tumors (decortication).

P/D surgery is usually only performed on stage 1 and 2 patients who have fully resectable (removable) mesothelioma.

In stage 2 and 3 patients who have metastasis (mesothelioma that’s spread) outside the pleura and into the lung tissues or chest wall, surgeons will also remove some of this affected tissue to prevent a recurrence.

In a more radical procedure, surgeons also remove the pericardium and/or the diaphragm.

Which Surgery Is Right for Me?

You can make an informed choice between extrapleural pneumonectomy and pleurectomy with decortication surgery by working with a pleural mesothelioma specialist. Only an experienced mesothelioma doctor can help you choose the right course for you.

EPP vs P/D

Patients should be aware that there is a contentious debate in the mesothelioma treatment community over which of these two procedures offers better long-term benefits for the patient.

Both of these procedures have benefits and risks, and it is important for patients to discuss the pros and cons with their medical team to understand which option is best for them

While some patients can still have a high-functioning and high-quality life with only one lung, some experts feel that removing the lung is unnecessary. Proponents of the EPP say it’s the best way to prevent a recurrence.

Be sure to discuss both surgical options thoroughly with your team of specialists to determine which procedure is right for you.

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Peritoneal Mesothelioma Surgery

Peritoneal mesothelioma patients have the best prognosis of all three disease locations, thanks in part to cytoreductive surgery. This highly technical procedure has enabled many peritoneal mesothelioma patients to survive well past their original life expectancy.

Cytoreduction With HIPEC

During cytoreductive surgery, the surgeon opens up the peritoneal cavity and removes the peritoneum (peritonectomy) along with any visible tumors within the abdomen.

Heated chemotherapy (HIPEC) drugs are then applied to the open abdomen to kill any unseen cancer cells.

Cytoreduction surgery can be performed on peritoneal mesothelioma patients of early or advanced stages, depending on the individual patient.

Pericardial Mesothelioma Surgery

Pericardial mesothelioma is extremely rare and most cases aren’t diagnosed until the autopsy.

If patients receive an early diagnosis and they are good candidates for surgery, then surgeons will perform a pericardectomy.

During a pericardectomy, the surgeon removes the diseased pericardium and any tumors surrounding it. Due to its high risk for complications, only highly skilled cardiac oncological surgeons can conduct such a complex procedure.

Top Doctors for Mesothelioma Surgery

To properly undergo mesothelioma surgery, you need to work with a specialized mesothelioma surgeon.

Unlike general oncologists, mesothelioma specialists are cardiothoracic or gastrointestinal oncological surgeons specializing in mesothelioma.

Three of the top mesothelioma surgeons available to treat new patients include:

Visit the UCLA Health website to learn more about Dr. Robert Cameron.

The Mesothelioma Justice Network has no affiliation with and is not endorsed or sponsored by Dr. Robert B. Cameron. The contact information above is listed for informational purposes only. You have the right to contact Dr. Cameron directly.

For more information on mesothelioma specialists, contact the Mesothelioma Justice Network today. Our team can answer your questions and help get you the treatment you deserve.

Don’t delay in getting potentially life-extending mesothelioma surgery.

Recovering from Mesothelioma Surgery

After mesothelioma surgery, you will need to gradually gain your strength back. Your doctors will monitor you at first to prevent dangerous complications.

Mesothelioma surgery recovery depends on the specific surgical procedure and the overall health of the patient.

Recovery Time for Mesothelioma Surgery

Recovery is generally between 4 and 8 weeks and can last as long as a year. You may need to remain in the hospital for up to 2 weeks following your surgery.

Remember that recovery times are different for everyone. The key to a successful recovery is patience, along with sufficient rest and regular communication with your medical team.

Mesothelioma Surgery Survival Rates

Unfortunately, mesothelioma has a generally poor prognosis with a 5-year survival rate in under 10% of patients.

However, mesothelioma surgery can greatly improve your lifespan and the survival rates after surgery vary depending on the stage and type of disease.

Surgical treatments for the three most common mesothelioma locations (pleural, peritoneal, and pericardial) have shown to increase survival rates

Pleural Mesothelioma Surgical Survival Rates

Most early-stage mesothelioma patients survive 2 years or longer after surgery. Surgical techniques are being refined all the time to improve these survival rates.

Peritoneal Mesothelioma Surgical Survival Rates

Cytoreduction with HIPEC has allowed the average patient to achieve a 5-year survival.

Pericardial Mesothelioma Surgical Survival Rates

Though there isn’t a lot of solid data to report, there are cases of patients undergoing pericardectomies and surviving for up to 2 years after surgery.

This is a massive improvement from the average 6-month life expectancy for pericardial mesothelioma patients.

Learn More About Mesothelioma Surgery

Mesothelioma is an important treatment option for patients to improve their survival and reduce painful symptoms. Depending on your care, you may be a good candidate for life-extending mesothelioma surgery.

You may feel overwhelmed while trying to access and understand your mesothelioma surgery options.

The Mesothelioma Justice Center team is available to provide you with more information and answer any questions you may have. Contact us today to learn more about mesothelioma surgery.

Author:Stephanie Kidd
Stephanie Kidd

Stephanie Kidd is the Editor-in-Chief of the Mesothelioma Justice Network and works tirelessly as a dedicated advocate for the vulnerable and underrepresented. Stephanie worked as a copywriter for an agency whose focus was communicating safety procedures on construction work sites. With her extensive background in victim advocacy and a dedication to seeing justice done, Stephanie works hard to ensure that all online content is reliable, truthful, and helpful.

Last modified: July 11, 2019

View 3 Sources
  1. American Cancer Society, “Surgery for Malignant Mesothelioma.” Retrieved from: https://www.cancer.org/cancer/malignant-mesothelioma/treating/surgery.html. Accessed on January 3, 2018.
  2. Medscape, “Malignant Pleural Mesothelioma Treatment Protocols.” Retrieved from: https://emedicine.medscape.com/article/1999348-overview. Accessed on January 3, 2018.
  3. Journal of Thoracic Disease, “Guidelines for the diagnosis and treatment of malignant pleural mesothelioma.” Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3886874/. Accessed on January 3, 2018.