Latest Mesothelioma Treatments
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Mesothelioma Surgery: Pleural Mesothelioma
One multimodality method has been surgery to remove all the tumor and then chemotherapy followed by radiotherapy. Although this extrapleural pneumonectomy (EPP) surgery is an aggressive procedure (the lung and the related coverings of the diaphragm and heart are removed), it has been found to remove the most tumor cells.
If you are unable to go through EPP surgery you might be able to have an pleurectomy/decortication procedure where the lung remains while the lung lining and tumor are removed - again followed by chemotherapy.
If you have advanced mesothelioma then surgery may not be an option and treatments will focus on chemotherapy.
Pleurodesis
Shortness of breath (a common first symptom) is typically caused by fluid building up (pleural effusion) between the lung and chest wall.
Pleurodesis is a surgical procedure that can prevent fluid build up by filling that space with an antibiotic or sterile talc which will irritate the linings and make then fuse.
Pneumeonectomy
A pneumeonectomy is a long-established lung cancer surgical procedure where the lung only is removed - however mesothelioma patients will generally have extrapleural pneumonectomy instead.
Extrapleural Pneumonectomy (EPP)
As stated above EPP surgery has been found to have the greatest outcomes and involves the removal of the lung and the affected lung, diaphragm and heart coverings.
To remove the lung it is first collapsed, the main blood vessels are tied off and then the main bronchial (air) tube is clamped and then cut - freeing the lung.
The pleura is then delicately removed from the chest wall as are affected sections of the diaphragm and pericardium which are replaced with Gore-Tex patches.
A chest drain is then inserted and the large chest incision closed.
A few days in ICU follow with a further week or more in hospital.
Pleurectomy
A pleurectomy aims to leave the lung in place while removing the tumor, the lung lining (visceral pleura) and chest wall lining (parietal pleura) and on occasion the removal of the lining of the diaphragm and around the heart.
In many cases it is not possible to remove the entire tumor but it can help control the build up of fluid and reduce pain. Consequently, this procedure is normally deemed to be a palliative rather than a cure.
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