Surgery
Those who are diagnosed with mesothelioma will be presented with several treatment options upon meeting with their oncologist. For most with this disease, surgery as a curative solution is generally not an option due to the late stage at which mesothelioma is normally diagnosed. However, a variety of surgical procedures may be suggested in order to help diagnose the disease, slow its progression, or lessen its side effects.
Many factors determine whether or not a mesothelioma patient is a candidate for various kinds of surgery. These include the stage of the disease, where it is located, the age of the patient, and his/her overall health, which determines whether the patient can withstand surgery and all its potential complications.
Diagnostic Surgeries
Often, a meso patient will need to undergo a simple surgical procedure that will help their doctor determine if they do indeed have the disease and to what extent it has progressed. Surgeries used for diagnostic purposes include:
- Biopsy – A biopsy is a common test for cancer diagnosis and involves removing a small amount of cells that can be tested for presence of the disease. An excisional biopsy is used to remove as much tissue as possible so as to control the spread of the cancer, while a needle biopsy removes a small amount of tissue from the area that is thought to be cancerous.
- Thoracoscopy – This procedure is performed in order to examine the pleura, the lining of the chest cavity. An incision is made in the chest and a long, thin tube with a light and magnifying glass on the end is inserted, allowing the surgeon to get a better look at the area. Today, many doctors employ the use of video-assisted thoracoscopy, which provides a better picture of the area.
- Thoracentesis – Using a thin needle, this procedure withdraws a small amount of fluid from the pleural area to test for cancer cells. Local anesthesia is used and the test is often proceeding by some sort of imaging test so that the surgeon knows from where to draw the fluid.
Major Surgeries
Though these surgeries have the potential of being “curative”, that is rarely the case with mesothelioma patients. Patients who are candidates for the surgeries below can expect that these procedures will remove as much of the cancer as possible. Thoracic surgeons most often recommend these surgeries for patients who are younger and are more likely to survive the procedure and the long recovery time.
- Pneumonectomy – Quite simply, this surgery involves the removal of the affected lung. This is a long and serious procedure and the recovery period can be quite difficult and painful. Candidates must be in overall good health and cannot have mesothelioma in both lungs.
- Extrapleural pneumonectomy – This surgery goes one step further from the pneumonectomy by also removing the areas around the affected lung, including the outer layer of the pleura and pericardium. Surgery is complicated and full of risks and recovery is very long. Only a handful of these procedures are performed on mesothelioma patients due to the risk of heart attack or other cardiac problems as well as gastrointestinal complications.
Palliative Surgeries
Often, doctors will recommend certain procedures to keep the patient more comfortable. These are known as “palliative” surgeries and usually involve reducing the debilitating side effects of mesothelioma. Some are done in the doctor’s office while others require a short hospital stay. Like all surgeries, some risk is present but the procedures generally provide relief and strive to help restore quality of life to the patient.
- Thoracentesis – This is a procedure that allows the doctor to withdraw any fluid that has built up in the pleural area, making it easier to breathe. For some meso patients, this palliative procedure may have to be performed several times. (Thoracentesis also has diagnostic uses, as previously indicated.)
- Pleurodesis – A more permanent solution to fluid build-up than thoracentesis, pleurodesis involves the introduction of talc into the pleural space, which then causes inflammation and prevents fluid accumulation. In many cases, this procedure will prevent the need for further thoracentesis.
- Paracentesis – Similar to thoracentesis, this procedure is used to ease the fluid build-up in the abdomen that happens with peritoneal mesothelioma.