Patients undergoing treatment for mesothelioma may be candidates for various types of surgical treatment. Surgical removal of the tumor is the best case scenario in cancer treatment, but it is not always possible. Mesothelioma tumors develop between the thin layers of the mesothelium. This makes the tumors very hard to see on an x-ray or CT scan until they have spread. The more a tumor spreads, the more difficult it is to remove. Even in cases where the doctor believes that he has removed the entire tumor, he will advise the patient to receive chemotherapy or radiation as a follow up. When surgery is performed on cancerous tumors, there is a risk of “seeding” the tumor. When this happens, microscopic tumor cells are left behind or spread to different organs, where they will continue to grow. Chemotherapy or radiation kills these tiny cells before they begin to grow again.
In the treatment of mesothelioma, there are two types of surgical intervention, curative and palliative. When a patient undergoes palliative surgery, the goal is to reduce the pain or symptoms of the disease. There is no cure. A patient undergoing curative surgery is hoping that the surgery will provide at least a partial cure for their cancer.
Because the physician often does not know what the situation will be when he begins surgery, he often must explain to the patient that the surgery, while hopefully curative, may indeed, only relieve some symptoms. There is often no way to determine this until the doctor performs the surgery.
Curative Surgery for Mesothelioma
The most common form of curative surgery for patients with mesothelioma is a pleurectomy/decortication. In the pleurectomy/decortication the doctor removes the pleural wall. He may also remove the lung on the side that is affected. If the lung is removed, the surgery is termed a pneumonectomy. The goal of this surgery is to remove all of the tumor, and some of the surrounding tissue as well.
Another surgery used for treating mesothelioma is the extrapleural pneumonectomy. This is an aggressive surgery. If you are a candidate for a extrapleural pneumonectomy your physician will probably refer you to a major cancer center for surgery. The qualifications for this surgery are extremely high. Aside from the mesothelioma, your doctor will require that you be in excellent health. The reason for this is the surgery can be dangerous, or even fatal, if performed on a patient that is not healthy enough to withstand the process. In the extrapleural pneumonectomy the physician removes not only the lining of the chest wall, but the pericardium, diaphragm and the lung that is on the side that is affected by the tumor. The surgeon then rebuilds the diaphragm and pericardium with prosthetic material.
In cytoreductive surgery the tumor is removed from the abdominal cavity. It is the surgical choice for patients with peritoneal mesothelioma. The physician attempts to remove as much of the tumor as possible, and the patient follows up with chemotherapy or radiation.
Palliative Surgery for Mesothelioma
Palliative surgery is used to reduce the symptoms of mesothelioma, and to make the patient more comfortable. There are several types of palliative surgery available that can improve the quality of life for the mesothelioma patient. Fluid build up is one of the most painful conditions related to mesothelioma. As the excess fluid builds up, it causes pain, shortness of breath and coughing.
Doctors can perform a procedure called thoracentesis. This process uses a needle to remove fluid from the pleural lining. Once the fluid is removed, the doctor will often inject talc into the area. This causes scar tissue to develop. The scar tissue prevents fluid from building up in the area. Another palliative surgery for the mesothelioma patient is pleurectomy/decortication. This is the same surgery that is performed for curative reasons, but can be performed on patients that have more advanced cancer as well. When the pleural lining is removed, it stops the production of fluid. Once this happens, much of the pain of mesothelioma is removed, and the patient has a much easier time breathing. This surgery does not, however, stop the progression of the cancer.
Preparation for Surgery
Preparing your body for surgery is an important part of the treatment process. With so little that you have control over, it can provide comfort and piece of mind that your body is ready for treatment. To prepare for surgery, it is important to eat healthy foods. In many cases of mesothelioma, the patient finds it difficult to eat. A patient that is losing weight and has a poor appetite may be considered a poor candidate for surgery. It is best to eat several small meals a day, and make every bite count. If your doctor does not prohibit it, a daily walk is also an excellent idea. By keeping your lungs exercised you will increase your odds of coming thorough the surgical procedure with minimal complications.