There are a variety of surgical procedures and treatments for pleural mesothelioma. Below is an overview of a few of the most frequent ones used in patients.
Pleurocentesis
This procedure is used to minimize pleural effusion, the build-up of fluid in the pleural space surrounding the lungs. The fluid can make it difficult for a mesothelioma patient to breath. The procedure involves the surgical puncture and drainage of the thoracic cavity and is usually performed in an outpatient setting with a long, thin needle that is inserted into the pleural space.
Pleurodesis
Pleurodesis is a surgical procedure that uses chemicals, talc or drugs to scar the space between the layers of the pleura. First, fluid is drained from the space using a catheter or chest tube. Next, the chemical, talc or drug is put into the space. The scarring stops the build-up of fluid in the pleural cavity. This is sometimes referred to as a “talc procedure.”
Pleurectomy / Decortication
Pleurectomy / Decortication refers to a lung-sparring surgery to remove the mesothelioma cancer by removing part of the covering of the lungs, lining of the chest, and part of the outside surface of the lungs. The goals of the operation are to re-expand the lung and remove the disease process affecting the pleural space so that pulmonary (lung) function and symptoms will improve.
Pneumonectomy
A pneumonectomy is a surgery that involves the removal of the lung that has been affected by mesothelioma. It has become the standard surgery for operable locally advanced lung cancer.
Extrapleural Pneumonectomy
An Extrapleural Pneumonectomy or EPP is the most invasive surgery for mesothelioma and involves the removal of the diseased lung, part of the pericardium, (the membrane that covers the heart), part of the diaphragm (the muscle that lies between the abdomen and the lungs), and part of the parietal pleura (this is the membrane that lines the chest). An EPP is typically performed only on patients with early stage localized disease that has not metastasized to the lymph nodes or to other tissues and organs. Sometimes heated chemotherapy is introduced during an EPP in order to bathe affected tissues. Although an EPP can impact life expectancy for some patients, there can be significant risks to this procedure. These risks may include: internal bleeding, respiratory failure, infection and blood clots. In addition, some patients undergoing extrapleural pneumonectomy die during or immediately following the procedure. That percentage is, however, lower at medical centers that specialize in this surgery.
Controversy
Perhaps the greatest area of dispute now is whether an extrapleural pneumonectomy (EPP) or pleurectomy / decortication is the most appropriate curative operation for mesothelioma patients who are candidates for both procedures. There are leading mesothelioma surgeons who take contrary point of view. For example, Dr. Robert Cameron at UCLA has endorsed a lung sparring approach while Dr. David Sugarbaker of Brigham and Women’s Hospital has advocated for EPP. The 2011 MARS study (Mesothelioma and Radical Surgery randomized feasibility study) concluded that, “radical surgery in the form of EPP within trimodal therapy offers no benefit and possibly harms patients.”
Surgical Treatments for Peritoneal Mesothelioma
Paracentesis
Similar to pleurocentesis, paracentesis is a procedure in which fluid from the abdomen is removed through a needle. It is performed on peritoneal mesothelioma patients to remove pressure from the fluid.
Peritonectomy / Cytoreductive Surgery
Peritonectomy is the most common surgical procedure for peritoneal mesothelioma and involves the removal or stripping of the affected peritoneum (cancerous part of the lining of the abdominal cavity) from the underlying tissue. Peritonectomy is usually combined with cytoreductive surgery where the goal is to also remove as much of the cancerous growth as possible from multiple sites in the abdomen. The greater omentum is nearly always involved and has to be removed.
HIPEC
Doctors often perform cytoreductive surgery in combination with other mesothelioma treatments such a chemotherapy. For example, in a HIPEC procedure (heated intraperitoneal chemotherapy), surgeons introduce heated chemotherapy directly into the surgical cavity. In the peer reviewed medical literature, HIPEC procedures used in peritoneal mesothelioma management report superior survival statistics when compared to other surgeries.
Related Posts
Peritoneal Mesothelioma and Palliative CRS/HIPEC Surgery-Peritoneal mesothelioma is the second most common form of asbestos cancer. Peritoneal mesothelioma affects the membrane around the abdominal organs. It can spread throughout the abdomen. Some peritoneal mesothelioma patients get good results with cytoreductive surgery. But success depends on many different factors. Surgical oncologists at the Medical College of Wisconsin are studying this question. Considering Surgery for Palliative Intent? Malignant mesothelioma is an especially aggressive cancer. The two primary types are pleural and peritoneal. Peritoneal mesothelioma used to be considered just as lethal as the more common pleural mesothelioma. But cytoreductive surgery (CRS) and intraperitoneal chemotherapy (HIPEC) have changed that. CRS involves removing as many of the cancer cells as possible. After surgery, the abdomen is cleaned with heated … Continue reading Peritoneal Mesothelioma and Palliative CRS/HIPEC Surgery»
Top Three Factors Predicting Mesothelioma Survival are Age, Histological Type, and Surgery Status-Malignant pleural mesothelioma is a rare and aggressive malignancy with a dismal prognosis. A new study is predicting mesothelioma survival among male and female patients in the United States. Identifying factors “associated with mesothelioma mortality is important research given the poor prognosis” according to Dr. Bian Liu from the a Icahn School of Medicine at Mount Sinai in New York. A new study applied a machine-learning algorithm to 12,210 patients to predict survival. The top three factors were age, histological type, and cancer-directed surgery status. Analyzing Over 12,000 Mesothelioma Patients Scientists from the New York State Department of Health included 12,210 mesothelioma patients. They involved only malignant pleural mesothelioma patients. They excluded cases with unknown diagnostic confirmation and unknown survival … Continue reading Top Three Factors Predicting Mesothelioma Survival are Age, Histological Type, and Surgery Status»
A Multimodality Treatment Plan may be Best for Pleural Mesothelioma-A multimodality treatment plan may improve mesothelioma patient outcomes. Malignant pleural mesothelioma is an invasive, locally aggressive tumor related to asbestos exposure. A new study shows that the best treatment plan for pleural mesothelioma may be when different types of therapy work together. The ideal combination of treatment therapies is still unknown. But a recent study encourages further studies on a multimodality treatment plan. This may include chemotherapy, surgery, and adjuvant radiotherapy. Current Clinical Guidelines: A History of Single or Multimodality Treatment Plans Despite a long history of clinical research, there is still no cure or any evidence of the best treatment. Many single-treatment plans, single-modality plans, have had disappointing results. Researchers have begun to evaluate different multi-modal treatment approaches. … Continue reading A Multimodality Treatment Plan may be Best for Pleural Mesothelioma»
Quality of Life Similar Regardless of Pleural Mesothelioma Surgery Type-New research suggests that the two major types of pleural mesothelioma surgery have about the same impact on patients’ quality of life afterward. Thoracic surgeons at Switzerland’s University Hospital Zurich compared the results of 42 mesothelioma patients. Patients had either extrapleural pneumonectomy (EPP) or lung-sparing PD surgery between 2013 and 2017. Patients answered questions about their health in the weeks and months after pleural mesothelioma surgery. Their answers show that, where post-surgical quality of life is concerned, it may not matter which procedure a person has. Two Approaches to Pleural Mesothelioma Surgery Pleural mesothelioma tumors start on the membranous tissue (pleura) that surrounds the lungs. A healthy pleura is thin and flexible and expands to accommodate the lungs during respiration. … Continue reading Quality of Life Similar Regardless of Pleural Mesothelioma Surgery Type»
Korean Cancer Doctors Embrace PIPAC for Mesothelioma-Five out of ten Korean oncologists surveyed feel positive about using an aerosolized chemotherapy system called PIPAC for mesothelioma and other types of cancer. PIPAC stands for pressurized intraperitoneal aerosol chemotherapy. The system turns liquid chemotherapy drugs into a spray that can be applied with a nebulizer. It was developed to treat surface malignancies like peritoneal mesothelioma that can be hard to treat with standard methods. PIPAC can be used in conjunction with mesothelioma surgery or by itself as either a palliative or curative treatment. The technology is still very new. Many doctors have never used it. But research conducted by the Seoul National University College of Medicine shows Korean doctors are ready to embrace it. How Spray-on Chemotherapy Works … Continue reading Korean Cancer Doctors Embrace PIPAC for Mesothelioma»
Glucose Solution May Prevent Complication After Pleural Mesothelioma Surgery-There is new evidence that a solution of hypertonic glucose can help correct persistent air leak – a complication that sometimes occurs after major pleural mesothelioma surgery. Pleural mesothelioma affects the membrane that surrounds the lungs. Efforts to surgically separate a mesothelioma tumor from the surface of the lungs can damage the lungs. When this damage causes air to seep out of the lungs into the chest cavity, it is an air leak. Some air leaks fix themselves within a few days. But when an air leak persists for more than 5 days, it can cause further complications and slow recovery after pleural mesothelioma surgery. A team of thoracic oncologists in Milan, Italy say hypertonic glucose can help clear up … Continue reading Glucose Solution May Prevent Complication After Pleural Mesothelioma Surgery»
Surgery-Based Multimodal Treatment Improves Survival for Italian Mesothelioma Patients-A new Italian report suggests that a surgery-based multimodal treatment approach to mesothelioma can help patients live longer with few serious side effects. The new study comes from Careggi University Hospital in Florence. Thoracic oncologists tracked the outcomes of 12 of their mesothelioma patients since 2017. All of the patients had early-stage pleural mesothelioma of the epithelioid subtype. Results showed that none of them died within the first year after surgery-based multimodal treatment. More than half lived for at least three years. These are considered very positive results for a cancer that often claims lives within months of diagnosis. Understanding Surgery-Based Multimodal Treatment Some types of cancer can be successfully treated with just one type of therapy. Pleural mesothelioma is … Continue reading Surgery-Based Multimodal Treatment Improves Survival for Italian Mesothelioma Patients»
Mesothelioma Surgical Decisions: New Method May Make Them Easier-Cancer researchers in India and the UK have come up with a method for making better mesothelioma surgical decisions. The group focused on peritoneal mesothelioma, the second most common form of asbestos cancer. Peritoneal mesothelioma affects the membrane around the abdominal organs. It can spread throughout the abdomen. Some peritoneal mesothelioma patients get good results with cytoreductive surgery. But success depends on a number of factors such as how far cancer has spread and where mesothelioma tumors are located. The new decision-making tool reminds doctors of five important factors to consider when making mesothelioma surgical decisions for the best outcomes. It is based on the acronym PAUSE. Peritoneal Mesothelioma and the Promise of CRS/HIPEC Malignant mesothelioma is an especially aggressive … Continue reading Mesothelioma Surgical Decisions: New Method May Make Them Easier»
New Mesothelioma Trial to Test Tri-Modal Approach-Enrollment is open for a new mesothelioma trial run by Memorial Sloan Kettering Cancer Center to test a three-prong approach to treatment. Pleural mesothelioma is a lung-related cancer caused by asbestos. It is notoriously difficult to treat and highly aggressive. The new mesothelioma trial aims to recruit 150 pleural mesothelioma patients. Patients will receive lung-sparing surgery and chemotherapy. Some will also receive intensity modulated radiation therapy (IMRT). Researchers will test which group does better – those who only have surgery and chemotherapy or those who also have targeted radiation therapy. They plan to measure not only survival but also complications, quality of life, and how long it takes for the cancer to come back. Tri-Modal Treatment to Fight Mesothelioma The … Continue reading New Mesothelioma Trial to Test Tri-Modal Approach»
Empyema After Mesothelioma Surgery: Avoiding a Serious Complication-A new study of a rare condition called empyema after mesothelioma surgery shows it can dramatically lengthen hospital stay and shorten survival. Empyema refers to pockets of pus in the pleural space around the lungs. It is the result of a lingering bacterial infection. Empyema is a serious complication in people who have surgery for pleural mesothelioma. The new study comes from the International Mesothelioma Program at Boston’s Brigham & Women’s Hospital. It finds that patients with empyema after mesothelioma surgery live half as long as those without it. They also spend a lot more time in the hospital. The researchers say air leaking from the lungs can raise the risk for this complication. In their new report, they offer … Continue reading Empyema After Mesothelioma Surgery: Avoiding a Serious Complication»
“My Name is Paul Kraus and I Have Survived Mesothelioma for Over 20 Years.”
In 1997 I was diagnosed with mesothelioma. The doctors gave me just a few short months to live...
But here I am, 20 years later, alive and well.
I wrote a book explaining how I became the longest living mesothelioma survivor in the world.
Today, I'd like to give you a copy for free because I want more people to survive this disease.
All you have to do is click the button below now. You will receive the book within 72 hours.