Researchers at the Hyogo College of Medicine have found that pleurectomy/decortication surgery can improve quality of life in mesothelioma patients, even if they have declining lung function. The researchers looked at 45 patients who received pleurectomy/decortication surgery between the years 2014 and 2018. After the patients received surgery, lung function tests showed that most of the pleural mesothelioma patients could not breathe very well compared to before the surgery. They also had a decrease in energy, vitality, and social functioning. The patients did however have better mental health and less pain. The researchers concluded that quality of life after pleurectomy/decortication surgery is not closely tied to breathing like previously thought.
Pleurectomy/decortication surgery is one of the two major surgeries for mesothelioma. The surgery involves removing diseased tissue without removing the lungs. The mesothelioma tumor, pleural lining, all or part of the diaphragm, and other tissue that could grow mesothelioma tumors are removed from the body. This is the preferred method compared to the more aggressive extrapleural pneumonectomy, which removes one of the lungs as well. Patients who receive this treatment usually have less pain, fewer complications, and a faster recovery.
The researchers at the Hyogo College of Medicine asked 65 pleurectomy/decortication surgery patients to undergo pulmonary function tests and complete a health survey. They did the surveys and tests a few times before the surgery and three, six, and 12 months after. Forty-five of the patients completed the survey. The patients reported that their physical function went from a value of 78 to 65 after the surgery. The patients’ abilities to perform physical roles also went down to a 41 from a value of 69. Their general health perceptions, vitality, and social functioning also decreased but returned to the baseline after a certain period of time.
Other values that decreased include body pain which went down from a 74 to 52. The value dropped to 62 after surgery but went lower after recovery. Mental health improved from 58 to 70. Thirty-eight of the patients performed pulmonary function tests after surgery. Their forced vital capacity declined from 98 percent to 61 percent. The air they could exhale also lowered from 93 percent to 67 percent and never increased. Since the patients’ mental health increased without their breathing improving, pulmonary tests are not the only metric for quality of life after pleurectomy/decortication surgery for mesothelioma. Doctors need to look at mental health and other factors when deciding if pleurectomy/decortication surgery is successful for mesothelioma patients.
