Surgery is the most common treatment for malignant mesothelioma. It can be used in combination with chemotherapy and radiation therapy to treat the cancer, or as a last resort when other treatments are not working. The type of surgery will depend on the location and size of the tumor.
Surgery is one of the most common treatments for malignant mesothelioma, but it’s not always successful. If surgery does not work, doctors may recommend chemotherapy or radiation therapy to try to shrink tumors or kill cancer cells.
Treatment Options for Malignant Mesothelioma
Treatment options for malignant mesothelioma depend on how early the cancer was detected and how far it has spread.
- Surgery: Surgery is an option for people who have early-stage mesothelioma. The surgeon removes any part of the lung or chest wall that has been affected by cancer cells.
- Chemotherapy: Chemotherapy is a treatment option for people with advanced-stage mesothelioma. It uses drugs to kill cancer cells or stop them from growing and dividing quickly.
- Radiation therapy: Radiation therapy is another option for people with advanced-stage mesothelioma. It uses high-energy X-rays to kill cancer cells or stop them from growing and dividing quickly.
- Immunotherapy: Immunotherapy is a treatment choice for people with advanced-stage mesothelioma. It uses the body’s natural defense system to target and kills cancer cells.
What is Surgery Used For?
There are three main reasons your healthcare provider may choose surgery as an option for your mesothelioma.
- Diagnostic surgery: This is usually a biopsy, and allows doctors to diagnose mesothelioma and determine the cell type definitively.
- Palliative surgery: This can help alleviate the symptoms associated with your mesothelioma, such as breathing difficulties and pain.
- Curative surgery: This is when surgeons can remove all visible signs of mesothelioma from your body.
Questions to Ask Your Surgeon
The first thing to do is to find a top surgeon. Once you have found the right surgeon, it is important to prepare for surgery. New patients should be prepared with a list of questions and concerns that they want to ask their surgeon before the surgery date.
Here are some questions that you may want to ask your surgeon:
- What kind of anesthesia will be used?
- Will I need any preoperative tests?
- What kind of preoperative care should I take?
- What can I expect during my recovery after surgery?
- How long will my recovery take?
- Can I drive myself home after the surgery, or do I need someone else?
- Do you have any other recommendations for preparing for surgery that I should know about before my procedure date?
Who is Surgery Suitable For?
Surgery is a common treatment option for mesothelioma, but not everyone is a candidate for it. For example, patients who have a weakened immune system or other health problems may not be able to undergo this type of surgery. Those who are considering surgical treatment should discuss their options with their doctor and find out which type of surgery they would be most suitable for.
Types of Surgeries for Malignant Mesothelioma
There are many different types of surgery for malignant mesothelioma, depending on the location and the stage at which it is diagnosed. There is currently no standard surgical treatment for mesothelioma, and so your doctors will determine the best procedure for your case.
Biopsy
A biopsy is a surgical procedure, which involves the removal of a sample of tissue for examination. It is the most common procedure used to diagnose cancer. A biopsy can be used to diagnose mesothelioma in the pleura, peritoneum, or pericardium.
A biopsy can be done in many ways depending on where the tumor is located and what type of tissue it is made up of. In some cases, a needle may be inserted into the tumor and fluid may be withdrawn for examination. The doctor may also make an incision in the skin or use instruments such as forceps to remove a piece of tissue from a tumor that cannot easily be reached through other means.
The two most common types of biopsies are fine needle aspiration (FNA) and core needle biopsy (CNB).
- FNA involves using an extremely thin needle to take cells from an enlarged lymph node or suspicious area on the skin or lung surface.
- CNB is done by inserting a needle through the skin and into the tumor to remove a piece of it. In some cases, a surgical operation like an excisional biopsy can be required.
The cells that are removed from the tumor with a biopsy are examined under a microscope for any signs of cancerous or precancerous tissue. The cells can also be tested to determine their genetic characteristics, looking at mutations in DNA strands or chromosomes that may allow doctors to determine the cell type.
Fluid Drainage
Fluid drainage is a minimally invasive technique that can be used to treat malignant mesothelioma. It involves inserting a catheter through an incision in the skin into one or both pleural cavities and removing fluid from them until they are clear. This treatment can be done on an outpatient basis with minimal recovery time, and it has been shown to improve breathing and quality of life for patients with malignant mesothelioma.
Pleurodesis
Pleurodesis is a surgical procedure that closes the pleural space. It is used to treat malignant mesothelioma, a cancer of the lung or chest cavity lining.
This procedure can be done through open surgery or thoracoscopically.
- In open surgery, an incision is made in the chest, and a catheter is inserted into the pleural space.
- In thoracoscopic surgery, a small incision is made, and a tube with a camera on it is inserted into the chest. The surgeon then puts talc powder in the pleural space to create pressure and closes off any holes that may be present.
This procedure aims to eliminate any air trapped in the pleural space and prevent fluid from leaking into it from other body parts. This will also prevent lung infections from occurring as well as help relieve pain caused by the movement of fluid around your lungs.
Cytoreductive Surgery (Debulking)
Debulking is a surgery in which the tumor is removed, but some of the healthy tissue is also removed. It is done to relieve symptoms and improve quality of life.
In this type of surgery, a surgeon makes an incision in the affected area and removes all visible or palpable tumor tissue. This can be done through different approaches:
- Open surgery: The surgeon makes an incision in the skin to expose the tumor and then cuts out all visible or palpable tumor tissue.
- Laparoscopic surgery: A small incision is made near or at the navel, and surgeons insert a camera into it to see inside your abdomen; they then remove all visible or palpable tumor tissue inside your abdomen.
Peritonectomy
Peritonectomy is a surgical procedure where the peritoneum is removed from the abdominal cavity and then replaced. It is typically performed for malignant mesothelioma but can also be used for other conditions, such as peritoneal carcinomatosis.
The peritoneal lining can be removed in many ways:
- open surgery
- laparoscopy
- video-assisted thoracoscopic surgery (VATS)
The most common method of removing the lining is to make an incision in the abdomen and remove it through that opening.
Surgical Resection
Surgical resection is an operation that removes a tumor or growth from inside the body. It is often used for malignant mesothelioma because it offers a chance of slowing or stopping the growth and spread of cancer cells if conducted in the early stages of mesothelioma.
Pleurectomy and Decortication (P/D)
Pleurectomy and Decortication (P/D) is a surgical procedure used to treat malignant mesothelioma. The goal of the procedure is to remove the cancerous lining of the lung, pleura, and chest wall. This surgery can be performed with or without chemotherapy or radiation therapy.
Extrapleural Pneumonectomy (EPP)
EPP is a surgical procedure used to treat malignant mesothelioma. It was initially considered the only curative treatment for this type of cancer.
The surgery involves removing the entire lung and chest wall lining, including the lining covering the heart and some surrounding tissue. The surgeon removes all tumor cells from these surfaces and any other cancerous cells found in nearby lymph nodes.
Side Effects of Surgery
Side effects of surgery for malignant mesothelioma include: infection, bleeding, and damage to nearby organs.
The side effects of surgery for malignant mesothelioma can depend on what type of surgery was performed. Side effects from open surgery can include infection, bleeding, and damage to nearby organs. Side effects from closed surgery can include injury to the lining of the chest cavity (pleura) or lung tissue that could lead to breathing problems or pneumonia.
What’s Next After Surgery for Malignant Mesothelioma?
After surgery for malignant mesothelioma, it is important to take care of yourself and your body to avoid complications. It is also important to know the next steps after surgery.
A few things you can do after surgery for malignant mesothelioma are:
- Take medications as prescribed by your doctor
- Eat a healthy diet
- Exercise regularly
- Keep your weight at a healthy level
While surgery for mesothelioma is rarely curative, it can slow the cancer’s progress, control symptoms, and sometimes enable people to live longer than they would have without it.
