Surgery for mesothelioma
Surgery for some types of mesothelioma might be done to try to bring about a cure or to
relieve symptoms. Surgery to relieve symptoms (called palliative surgery) is often done
in cases where the tumor has already spread or when the patient is too sick to go through
more involved surgery.
To attempt a cure, major surgery might be needed. This might be done if the patient is in
good health (other than the cancer) and if it seems as if the tumor is only in one place.
While surgery is not likely to cure the cancer, it might extend the patient's life.
But in most cases the cancer has spread to other places before it is found. So the role of
surgery in treating this cancer is not clear. If your doctor recommends surgery, ask for
more details about the operation and what the goal is.
Surgery for pleural mesothelioma
There are 2 types of surgery that could be used if you have mesothelioma in the linings of
the lungs. One is a bigger operation that attempts to remove all or most of the cancer and
some of the tissues around it. (This surgery is called an extrapleural pneumonectomy or
EPP.) This is a complex operation and is done only by surgeons in large medical centers.
You must be in good overall health with good lung function and no other serious illnesses
in order to have this surgery.
The other type of surgery that may be used is called a pleurectomy/decortication or P/D.
This smaller operation may be done to try to cure some cancers, but it is more often used
to relieve symptoms in cases where the whole tumor cannot be removed. It can help
control the build-up of fluid, improve breathing, and decrease pain caused by the cancer.
An even smaller surgery called debulking might be done to remove as much of the
mesothelioma as possible.
Surgery for peritoneal mesothelioma
These tumors are often too advanced to be removed completely. Palliative surgery may
be an option in some cases. The goal of this surgery is to relieve or prevent symptoms,
instead of trying to cure the cancer.
Debulking might be done to remove as much of the mesothelioma as possible. Sometimes
this means removing pieces of the intestine.
The omentum is an apron-like layer of fatty tissue that drapes over the contents of the
abdomen. Cancers involving the peritoneum often spread to this tissue, so it may be
removed as part of surgery.
Surgery for pericardial mesothelioma
Operations can be done to remove a mesothelioma from the pericardium (the sac around
the heart).
Surgery for mesothelioma of the tunica vaginalis testis
Surgery for these mesotheliomas, which occur in the groin, rarely cures this cancer. Most
of the time surgery is done because the tumor looks like a hernia. The surgeon attempts to
treat a suspected hernia and only learns that it is cancer after the surgery is begun. This
kind of mesothelioma typically can't be removed entirely.
Other ways to relieve symptoms
In many cases, surgery may not be a good option, even to relieve symptoms. Other, less
invasive treatments may be used instead. While these methods can relieve symptoms,
they are not meant to cure the cancer.
Fluid in the chest can be removed by putting a needle into the chest cavity and drawing
the fluid out. Sometimes talc or drugs are then put into the chest. This causes the linings
of the lung and chest wall to stick together, sealing the space and keeping fluid from
building up.
Fluid in the abdomen (belly) or around heart can be removed by putting a long, hollow
needle through the skin, into the fluid, and removing it. Numbing medicine is used on the
skin before the needle is put in. This may be done in a doctor's office or in the hospital.
If the above methods don't work, a shunt might be put in the chest. A shunt is a device
that allows fluid to move from one part of the body to another. The shunt is a long, thin
tube with a small pump in the middle. In the operating room, the doctor puts one end of
the shunt into the chest cavity and the other end into the abdomen (belly). Once the shunt
is in place, the patient uses the pump (which is just under the skin) several times a day to
move the fluid from the chest to the abdomen, where it is more likely to be absorbed by
the body.
Another approach sometimes used to control the build-up of fluid is a catheter -- a thin
flexible tube. One end of the catheter is put in the chest or abdomen and the other end is
left outside the body. This is done in a doctor's office or hospital. Once in place, the
catheter can be attached to a special bottle or other device to allow the fluid to drain out.
Radiation therapy for mesothelioma
Radiation therapy is treatment with high energy rays (such as x-rays) to kill cancer cells
or shrink tumors. The radiation may come from outside the body (external radiation) or
from radioactive materials put right into the tumor (brachytherapy).
External radiation is the preferred type for mesothelioma. It is given in the same way as
an x-ray used to find a broken bone, but it takes longer. Treatments are usually given 5
days a week for several weeks.
As a rule, it is hard to treat mesothelioma with radiation. It is not easy to aim the radiation
just at the cancer without affecting nearby healthy areas such as the lungs. But radiation
may be used in different ways to treat mesothelioma:
· It can be used after surgery to try to kill any small deposits of cancer that could not be
seen and removed during surgery.
· It can be used to ease symptoms of mesothelioma such as shortness of breath, pain,
bleeding, and trouble swallowing.
There can be side effects from radiation. Most of these will go away over time after
treatment ends. The skin in the area treated may look sunburned and then become darker.
You may also feel tired. Be sure to talk with your doctor about any side effects. Often
there are medicines or other things that can be done to help control them.
To learn more about radiation treatment, please see Understanding Radiation Therapy: A
Guide for Patients and Families.
Surgery for some types of mesothelioma might be done to try to bring about a cure or to
relieve symptoms. Surgery to relieve symptoms (called palliative surgery) is often done
in cases where the tumor has already spread or when the patient is too sick to go through
more involved surgery.
To attempt a cure, major surgery might be needed. This might be done if the patient is in
good health (other than the cancer) and if it seems as if the tumor is only in one place.
While surgery is not likely to cure the cancer, it might extend the patient's life.
But in most cases the cancer has spread to other places before it is found. So the role of
surgery in treating this cancer is not clear. If your doctor recommends surgery, ask for
more details about the operation and what the goal is.
Surgery for pleural mesothelioma
There are 2 types of surgery that could be used if you have mesothelioma in the linings of
the lungs. One is a bigger operation that attempts to remove all or most of the cancer and
some of the tissues around it. (This surgery is called an extrapleural pneumonectomy or
EPP.) This is a complex operation and is done only by surgeons in large medical centers.
You must be in good overall health with good lung function and no other serious illnesses
in order to have this surgery.
The other type of surgery that may be used is called a pleurectomy/decortication or P/D.
This smaller operation may be done to try to cure some cancers, but it is more often used
to relieve symptoms in cases where the whole tumor cannot be removed. It can help
control the build-up of fluid, improve breathing, and decrease pain caused by the cancer.
An even smaller surgery called debulking might be done to remove as much of the
mesothelioma as possible.
Surgery for peritoneal mesothelioma
These tumors are often too advanced to be removed completely. Palliative surgery may
be an option in some cases. The goal of this surgery is to relieve or prevent symptoms,
instead of trying to cure the cancer.
Debulking might be done to remove as much of the mesothelioma as possible. Sometimes
this means removing pieces of the intestine.
The omentum is an apron-like layer of fatty tissue that drapes over the contents of the
abdomen. Cancers involving the peritoneum often spread to this tissue, so it may be
removed as part of surgery.
Surgery for pericardial mesothelioma
Operations can be done to remove a mesothelioma from the pericardium (the sac around
the heart).
Surgery for mesothelioma of the tunica vaginalis testis
Surgery for these mesotheliomas, which occur in the groin, rarely cures this cancer. Most
of the time surgery is done because the tumor looks like a hernia. The surgeon attempts to
treat a suspected hernia and only learns that it is cancer after the surgery is begun. This
kind of mesothelioma typically can't be removed entirely.
Other ways to relieve symptoms
In many cases, surgery may not be a good option, even to relieve symptoms. Other, less
invasive treatments may be used instead. While these methods can relieve symptoms,
they are not meant to cure the cancer.
Fluid in the chest can be removed by putting a needle into the chest cavity and drawing
the fluid out. Sometimes talc or drugs are then put into the chest. This causes the linings
of the lung and chest wall to stick together, sealing the space and keeping fluid from
building up.
Fluid in the abdomen (belly) or around heart can be removed by putting a long, hollow
needle through the skin, into the fluid, and removing it. Numbing medicine is used on the
skin before the needle is put in. This may be done in a doctor's office or in the hospital.
If the above methods don't work, a shunt might be put in the chest. A shunt is a device
that allows fluid to move from one part of the body to another. The shunt is a long, thin
tube with a small pump in the middle. In the operating room, the doctor puts one end of
the shunt into the chest cavity and the other end into the abdomen (belly). Once the shunt
is in place, the patient uses the pump (which is just under the skin) several times a day to
move the fluid from the chest to the abdomen, where it is more likely to be absorbed by
the body.
Another approach sometimes used to control the build-up of fluid is a catheter -- a thin
flexible tube. One end of the catheter is put in the chest or abdomen and the other end is
left outside the body. This is done in a doctor's office or hospital. Once in place, the
catheter can be attached to a special bottle or other device to allow the fluid to drain out.
Radiation therapy for mesothelioma
Radiation therapy is treatment with high energy rays (such as x-rays) to kill cancer cells
or shrink tumors. The radiation may come from outside the body (external radiation) or
from radioactive materials put right into the tumor (brachytherapy).
External radiation is the preferred type for mesothelioma. It is given in the same way as
an x-ray used to find a broken bone, but it takes longer. Treatments are usually given 5
days a week for several weeks.
As a rule, it is hard to treat mesothelioma with radiation. It is not easy to aim the radiation
just at the cancer without affecting nearby healthy areas such as the lungs. But radiation
may be used in different ways to treat mesothelioma:
· It can be used after surgery to try to kill any small deposits of cancer that could not be
seen and removed during surgery.
· It can be used to ease symptoms of mesothelioma such as shortness of breath, pain,
bleeding, and trouble swallowing.
There can be side effects from radiation. Most of these will go away over time after
treatment ends. The skin in the area treated may look sunburned and then become darker.
You may also feel tired. Be sure to talk with your doctor about any side effects. Often
there are medicines or other things that can be done to help control them.
To learn more about radiation treatment, please see Understanding Radiation Therapy: A
Guide for Patients and Families.
