From the blog

Doctors Will Soon be Able to Test if Surgery is Safe for Mesothelioma Patients

Published: March 6, 2020

Doctors could soon know if surgery is the best option for mesothelioma patients. Surgery is one of the most effective ways to improve patients’ lives. The problem is that undergoing surgery is very stressful on people’s bodies, especially when they have cancer. It is better to know if surgery can be done before operating on a patient. A new study has tried to find out if there is a way to test whether patients should be having surgery. By looking at a diffuse chest wall invasion, doctors can find out if it is safe to remove a patient’s cancer or if other treatments should be considered.

Diffuse chest wall invasion occurs when the cancer spreads to other areas in the chest including the tissue, fat, muscles and bones. It is a common symptom of pleural mesothelioma. Surgeries that help mesothelioma patients include pleurectomy and decortication and extrapleural pneumonectomy. The lung, pleura, and part of the diaphragm are removed when going through an extrapleural pneumonectomy while a pleurectomy and decortication does not remove the lung. These are invasive surgeries and if a patient is not well enough to go through them, it is better not to operate. When a diffuse chest wall invasion occurs, the chest wall cannot be removed because of the stress on the body.

Diffuse chest wall invasions were not able to be detected until this study. The study looked at 170 pleural mesothelioma patients. Of the 170, 143 were able to be operated on while 27 could not because of the cancer’s spread. Doctors were able to determine that the patients who could not be operated on had a contraction of the ipsilateral hemithorax. This means that the half of the chest area shrunk where the cancer started.

Doctors measured the thoracic cage volume, which shows that cancer has spread. Researchers found that it was best for patients whose chests shrunk five percent or more to not undergo surgery. The decrease in size is compared to the size if no cancer is present. When looking at patients as surgery candidates, it can be determined if they are safe to be operated on before putting them through intensive surgery, helping doctors find the best solution for the patient.

Marc de Perrot, MD et. al., “Commentary: Is thoracic cage volume a new parameter for clinical staging in mesothelioma?” The Journal of Thoracic and Cardiovascular Surgery (January 7, 2020). [Link]
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