Pleural mesothelioma patients can be stronger and have better lung function a year after surgery than in the days and weeks immediately following their operation.
That’s the finding of Japanese researchers who just published a new study in Integrative Cancer Therapies.
They tested 24 male pleural mesothelioma patients in their 60s and 70s. They measured things like the mens’ grip strength, knee extension strength, and how far they could walk in six minutes. They also ran several tests on their lung function. They compared these test results with the patients’ own assessment of their outcomes.
The study suggests that patients who undergo P/D surgery can continue to improve beyond the postoperative phase. It is a hopeful message for patients and families grappling with the pros and cons of mesothelioma surgery.
Surgical Options for Mesothelioma
Pleural mesothelioma starts as tumors on the membrane that surrounds the lungs. As tumors grow, they constrict the lungs and trigger fluid buildup which makes it hard to breathe.
There are not many effective treatments for pleural mesothelioma patients. Multiple studies show that a combination of surgery and chemotherapy is often the best option for patients who are strong enough.
Surgeons are still divided over whether or not it is best to remove one of the lungs along with the cancerous tissues. Lung-removing mesothelioma surgery is called EPP (extrapleural pneumonectomy).
The patients in the new Japanese study had the more conservative approach called P/D (pleurectomy with decortication). Studies show this surgical procedure is less risky and may lead to faster recovery than EPP.
Post-Surgical Recovery for Pleural Mesothelioma Patients
There are different ways to evaluate how well pleural mesothelioma patients respond to treatment. One method is self assessment. The Japanese pleural mesothelioma patients completed a self-assessment of their health before and after their surgery. They completed it again a year after surgery.
But the researchers also did their own measurements of physical and lung function. Along with the grip and knee strength and walk distance tests, they measured how much air the mesothelioma patients could blow out and how quickly.
They found that patients’ assessments of their own health correlated with their capacity for exercise. They also found that both subjective and objective measures of their health improved the further out they were since surgery.
“Patients with MPM who underwent P/D demonstrated improved health utility and physical function when compared with their postoperative values in the convalescent phase,” writes lead author Takashi Tanaka, BSc, of Hyogo College of Medicine. “Short-Form Six-Dimension [self-assessment tool], six-mile walk distance, forced vital capacity (FVC), and forced expiratory volume in one second (FEV1) values one year operatively improved significantly compared with postoperative.”
Pleural mesothelioma patients who survive may breathe better a year after surgery than they do immediately postoperatively. But most studies show they rarely regain their full lung capacity. Several recent reports point to the value of rehabilitation for mesothelioma patients after surgery.
Tanaka, T, et al, “Relationship Between Physical Function and Health Utility in Patients Undergoing Surgical Treatment for Malignant Pleural Mesothelioma”, September 2, 2021, Integrative Cancer Therapies, Online ahead of print, https://journals.sagepub.com/doi/10.1177/15347354211043508