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Mesothelioma Surgical Options

Confirming and treating the disease

Doctors use surgery at various stages of the diagnosis and treatment of asbestos-related disease.  There are three categories of surgeries for mesothelioma: diagnostic, palliative, and potentially curative.

Diagnostic surgery for mesothelioma

Medical professionals use diagnostic surgery to investigate if the patient has the cancer and, if so, where it is located.  There are several types of mesothelioma diagnostic surgery:

  • Needle aspiration biopsy. The doctor uses a long needle to remove sample cells from the area where cancer is suspected.  These cells are then tested for the presence of mesothelioma.
  • Excisional biopsy. To determine how far the mesothelioma has spread, doctors remove as much of the cancerous tissue as possible to slow the spread of the disease.
  • Thoracentesis. Fluid is removed from the pleural spaces of the lungs through a long, hollow needle.  The fluid is sent to a lab for analysis.
  • Thoracoscopy. The doctor inserts a long, thin tube into the lungs, examines the pleura, and removes samples of suspected cancer cells for testing.

Palliative surgery for mesothelioma

Palliative surgery treats mesothelioma symptoms.  It provides some relief for the patient, but it does not significantly affect the outcome of the disease itself.  Palliative surgery for mesothelioma includes:

  • Chest tube drainage and pleurodesis. The doctor introduces a chemical that prevents additional fluid accumulation.  The fluid is drained using a chest tube.  If this fails, pleuroperitoneal shunting can provide some relief in patients with a trapped lung or other complications.
  • Paracentesis. The doctor removes fluid that builds up and causes pain in the abdomen of patients with peritoneal mesothelioma.

Surgery for mesothelioma

In surgery for mesothelioma, doctors try to remove all obvious diseased tissue.  Any remaining microscopic disease cells are then attacked with chemotherapy or radiation therapy.  Three main surgeries are available:

  • Pneumonectomy. This involves the removal of one lung.  It may be appropriate for patients with pleural mesothelioma in one lung or only part of the lung.
  • Pleurectomy/Decortication.  Pleurectomy is a procedure where the membrane lining the lungs and chest cavity (pleura) is removed, without removing the entire lung.
  • Extra-Pleural Pneumonectomy (EPP).  In EPP, the pleura, diaphragm, pericardium, and the whole lung involved with the tumor are removed.  This is considered a radical therapy, performed only by surgeons at centers specializing in these treatments.