Pleural mesothelioma is a rare and aggressive form of cancer that affects the lining of the lungs (pleura). Surgery is one of the treatment options for pleural mesothelioma, especially in combination with other therapies like chemotherapy and radiation. The goal of surgery is usually to remove as much of the cancerous tissue as possible to improve symptoms and potentially extend survival. Several surgical options may be considered for treating pleural mesothelioma:
- Extrapleural Pneumonectomy (EPP): This surgery involves the removal of the affected lung, part of the lining of the chest, the diaphragm, and sometimes part of the lining of the heart. It’s an aggressive procedure and is typically considered for patients with early-stage disease who are in good overall health.
- Pleurectomy/Decortication (P/D): Unlike the EPP, this surgery aims to remove the pleural lining affected by the cancer while preserving the lung. It involves removing the pleura where the cancer is present, along with any visible tumors. P/D is often considered for patients with early-stage mesothelioma who are not suitable candidates for the more extensive EPP.
- Cytoreductive Surgery: This type of surgery aims to remove as much of the visible tumor as possible. It may be combined with heated intraperitoneal chemotherapy (HIPEC) or heated intrathoracic chemotherapy (HITHOC), where heated chemotherapy drugs are delivered directly into the chest cavity to kill remaining cancer cells.
- Thoracoscopy or Video-Assisted Thoracic Surgery (VATS): These minimally invasive procedures involve making small incisions in the chest and using a camera and surgical instruments to biopsy or remove cancerous tissue. VATS is generally used for diagnostic purposes or for palliative procedures to relieve symptoms.
The choice of surgery depends on various factors, including the stage of the disease, the patient’s overall health and fitness for surgery, and the expertise of the surgical team. Not all patients are suitable candidates for surgery, especially if the cancer has spread extensively or if the patient has other health issues that make surgery risky.
It’s important for patients diagnosed with pleural mesothelioma to consult with a specialized team of oncologists, surgeons, and other healthcare professionals to discuss treatment options and create a personalized treatment plan that may include a combination of surgery, chemotherapy, radiation therapy, immunotherapy, and other treatments.