Pleural mesothelioma is a cancer mainly caused by asbestos exposure. It is a cancer of the pleura, which is a lining of the lungs. The outlook for the disease is poor, with a typical survival time after diagnosis being 9 to 20 months. The overall five-year survival rate is five percent. These numbers are slightly improving thanks to new treatments that involve surgery. A new article from Cancers explains the diagnosing, staging, and treatment of pleural mesothelioma.
Surgery is crucial for the diagnosis and staging of mesothelioma. When doctors perform surgery, tissue samples can be taken that help confirm the disease and identify what type it is. Correct staging, which is the process of determining how far the disease has spread, is important because it helps plan the correct treatment for mesothelioma. Multiple major health organizations recommend surgery as a key part of treatment for pleural mesothelioma. There are multiple types of surgery and treatments for the disease.
One type of surgery is pleurectomy/decortication. This procedure removes the lining of the lungs and chest wall. The goal of the procedure is to remove as much tumor material as possible while still allowing the lungs to function properly. It is not as radical as other surgeries, making it a safer alternative. Extrapleural pneumonectomy is another procedure for mesothelioma. It is more extensive with the affected lung, part of the diaphragm, the lining of the chest, and sometimes part of the heart’s lining being removed. It can completely remove the tumor but has much longer recovery times and has more risks associated with it. Another procedure is extended pleurectomy/decortication, which is a more thorough version of Pleurectomy/decortication surgery, aiming to remove all visible and touchable tumor tissues.
Surgery is incredibly important because it aims to achieve macroscopic complete resection, which is the removal of all visible tumors. This helps to improve survival rates. Combining surgery with other treatments like chemotherapy, radiation, or immunotherapy can lead to better long-term survival by targeting any remaining microscopic disease. The biggest choice some might have to make is whether to receive extrapleural pneumonectomy or pleurectomy/decortication for mesothelioma when candidates are eligible for both procedures.
Surgery also helps doctors identify which type of mesothelioma is present, which helps doctors choose the best available treatment for each individual patient. Not all patients are suitable candidates for surgery though. It is crucial for doctors to choose patients based on the stage of the disease, type of mesothelioma, overall health, and lung and heart function. To minimize risks associated with surgery, surgical procedures should be performed at specialized centers with experienced teams. When there are cases where curing the disease is not possible, surgery can help improve a patient’s quality of life by relieving symptoms.
Surgery is crucial for diagnosing, staging, and treating pleural mesothelioma. New treatments continue to be developed, but surgery is still there to improve the outcomes of patients. Complete tumor removal in the case of pleurectomy/decortication surgery or extrapleural pneumonectomy can improve survival, especially with those that have specific types of mesothelioma. Surgery will continue to evolve to enhance treatment effectiveness for mesothelioma patients.
