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Mesothelioma in US States

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Practice of Mesothelioma Surgeons

Catherine A. Murphy

Even though there no cure is for mesothelioma, scientists have developed various treatment methods to help reduce the suffering associated with the disease, surgery being the most common method utilized. Mesothelioma specialists may recommend surgery to remove the main mesothelioma tumor and nearby tissues taken over by these cancerous cells. However, if the mesothelioma is at its advanced stage, then mesothelioma surgery may prove difficult, as the tumor is likely to have spread to other areas.

For such a case, surgeons are likely to remove the excessive fluid from around the chest or abdomen area to provide pain relief. Before undergoing mesothelioma surgery or other alternative methods of treatment, patients must discuss any potential risks or adverse side effects that may occur with the mesothelioma specialist prior to taking a decision. Mesothelioma surgery is usually combined with chemotherapy or radiation. Through this combined treatment, the mesothelioma tumor is either reduced or removed and further tumor growth is controlled or stopped.

Surgery for Pleural Mesothelioma

There are different types of surgical practices that mesothelioma surgeons employ based on the type of mesothelioma cancer. They include:

• Pleurectomy or Decortication Surgery: involves the removal of the infected lung and surrounding area. This leads to a reduction of the size of the tumor along with reduced pain due to less pressure on the chest cavity. It also controls fluid accumulation. The treatment is considered to be palliative (reduces pain. but is not a cure). When combined with radiation and chemotherapy, this form of mesothelioma treatment has proved to increase the life expectancy of the patient. Another advantage of this type of mesothelioma surgery is that it has a low mortality rate as compared to more invasive mesothelioma surgery such as extrapleural pneumoectomy. This surgery is not possible if the tumor growth is extensive in the pleural space.
• Pneumonectomy Surgery: involves the removal of the entire lung. This type of surgery is employed when the cancer is in its advanced stages in order to relieve pain.
• Thoracentesis Surgery: involves draining excessive fluid from the lungs with the help of a needle. This eases breathing problems and relaxes the pressure on the lungs.
• Extrapleural Pneumonectomy Surgery: is an advanced type of surgery and complicated procedure performed during the initial stages of mesothelioma. It involves the total removal of the linings surrounding the lungs, linings around the heart and diaphragm to prevent further spreading of mesothelioma. This type of surgical procedure allows for the removal of extensive amounts of tumor cells.

Post- mesothelioma surgery usually involves radiation and chemotherapy to prevent further spreading of the disease. This type of mesothelioma surgery slows down the advancement of mesothelioma and improves the quality of life in some patients. Patients have an average survival time of 35 months as compared to a survival time of 9 months for those treated with palliative or pain–reducing treatment.

Surgical Practices Utilized for Other Types of Mesothelioma

Pericardial Mesothelioma

For pericardial mesothelioma, mesothelioma surgeons employ similar processes such as tissue removal to relieve pain and discomfort. This however does not cure the disease completely. Mesothelioma surgery is usually the last resort for patients as this process is expensive and not covered by most insurance companies.

Peritoneal Mesothelioma

Peritoneal mesothelioma surgery is usually not possible for everyone. If at all it is possible, then patients undergo a peritonectomy surgery to remove the peritoneum (the lining of the abdomen). Recently, doctors have introduced a new technique of surgery called ‘cytoreductive surgery’ for the treatment of this disease. In this technique, they conduct six different types of peritonectomy procedures to extract the maximum amount of the tumor. They then administer post surgery- chemotherapy directly to the peritoneal cavity.

Some doctors also administer a type of chemotherapy that is heated to a few degrees above body temperature referred to as hyperthermic intraoperative intraperitoneal chemotherapy (HIIC). This has proven to be very effective resulting in a survival rate of about 5 years. However, this process is still under clinical trail.

Thoracospic Surgery

Mesothelioma surgeons also utilize a video-assisted surgical technique referred to as ‘thoracoscopic surgery’ (VATS) for mesothelioma diagnosis. In this, various biopsies of the pleural lining, nodules, masses, and pleural fluid are done through a minimal invasive procedure along with other therapies such as pleurodesis for pleural effusions. Several small ports or incisions are made through the chest wall wherein a small camera is inserted along with specific instruments to take samples of tissue. With the help of a video screen, displayed images captured by the camera enables surgeons to complete all the necessary procedures. This procedure is a more viable option as compared to a thoracotomy, which involves a larger incision in order to reach the chest cavity.

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