Mesothelioma Surgery

Surgery for patients diagnosed with mesothelioma may be prescribed for any of the following three reasons:

• First of all, the doctor may need to confirm the diagnosis of mesothelioma and ascertain the exact location. Typically, a non-invasive surgery like biopsy may be performed for this.
• Secondly, surgery may be opted for curative reasons to remove as much of the cancerous tissues as possible. A trimodal approach that combines surgery with chemotherapy and radiation may be used.
• Thirdly, the intention of surgery may be to provide relief to the patient and ease his symptoms to improve the quality of life. The intent may not be curative.

Mesothelioma is caused by exposure to asbestos and symptoms surface after a very long gestation period spanning 20 to 50 years. As a result, many patients are diagnosed after the disease is in advanced stages and the patient comes to the doctor in a debilitated condition. In such a scenario, surgery is advised only to the strongest of mesothelioma patients. It may not be the best treatment option for those who are weak and likely to succumb to such aggressive measures.

An experienced mesothelioma doctor assesses the patient on parameters of age, medical record, disabilities, allergies, sex, and body weight to decide on the best line of treatment.

The operation will then take place. Surgery of mesothelioma consists of cutting open a patient and removing the majority of cancerous cells from either the lining of the lungs, abdomen or heart in an attempt to gain long term control over the cancer. Due to the proximity of the cancer to major organs of the body, the operation can only be performed by extremely skilled surgeons. There is a chance that a patient will die during the mesothelioma operation.

Peritoneal Mesothelioma Surgery

Mesothelioma that develops in the abdomen is called Peritoneal Mesothelioma; the name derives from the peritoneum or the lining that covers the stomach where the mesothelial cells proliferate into a cancerous form. Almost 20% of all cases of mesothelioma are categorized as Peritoneal Mesothelioma.

Peritoneal mesothelioma surgery involves cutting the abdomen to remove as much of the cancerous cells from the lining of the stomach as possible. At times, segments of the stomach may also be cut out. This type of surgery is called cytoreductive or debulking surgery and may take a number of hours to complete.

In the course of the surgery, drugs like cisplatin and doxorubicin which are very standard chemotherapy drugs may be injected into the abdominal cavities. This course of action is termed, Hyperthermic Intraoperative Intraperitoneal Chemotherapy or HIIC. Post surgery, the patient is kept on paclitaxel for five days which is a typical breast cancer chemotherapy drug. All these mesothelioma drugs are administered with the intent to inhibit the development of cancerous cells.

It is found that patients of Peritoneal Mesothelioma who opt for surgery generally live for more than 5 years.

Pleural Mesothelioma Surgery

Mesothelioma that develops in the lining of the lungs is called Pleural Mesothelioma; pleura or the lining that covers the lungs is where the mesothelial cells proliferate into a cancerous form. When infection of the pleural space is suspected, a chest X-ray may be performed to check out abnormal collection of pleural fluid. A pleural smear, histological analysis and/or molecular biologic analyses may also be done. If the tumor has grown through the diaphragm, it becomes very difficult to find out the place of origin.

Surgically removing a diseased lung is called pleural pneumonectomy. Since the symptoms of Pleural Mesothelioma overlap with other diseases of the lung, the disease may go undetected for a long time. Stage of cancer, age, and histology are important considerations for deciding on surgical intervention.

Surgery  of pleural mesothelioma may not be curative but it increases the patient’s life span which is reportedly 16 months without surgery. While survival improves, it is not certain how surgery impacts long-term survival.

Is Surgery A Cure For Mesothelioma?

No cure for mesothelioma is known to exist at present. Surgery is generally used for diagnostic and palliative purposes. It may form a part of a trimodal approach to treatment, along with chemotherapy and mesothelioma radiation therapy.

Recovery after a Mesothelioma Surgery

As with other critical operations, the patients generally remain in intensive care after mesothelioma surgeries. A respirator may be used for at least 24 hours after the surgery to ease the patient. After a couple of days, a patient with stable parameters and no complications is moved to a regular room. Rehabilitation may be started thereafter to restore normal functioning of the affected organ. In 10 days, the patient may be sent home provided recovery is on track while in the hospital.

While recovery is a slow process, regular non-strenuous activity may be performed at home and people with desk jobs have been known to return to work in eight weeks at times.