Posts Tagged ‘mesothelioma surgery’

Possible New Mesothelioma Treatment

Wednesday, November 16th, 2011

In June of 2011, the University of Pennsylvania’s Penn Medicine published the results of promising new research in the treatment of mesothelioma. The study, involving 28 patients, compared the traditional method of extrapleural pnumonectomy (EPP), which involves the removal of a lung, and a unique combination of lung-sparing surgery and photodynamic therapy (PDT). To the surprise of the researchers, the patients who received PDT and lung-sparing surgery have, as a group, shown an unusually long survival rate.

Mesothelioma is a very aggressive form of cancer that usually develops in the lining of the lungs called the pleura. Initially, mesothelioma tends to develop slowly, usually developing 10 to 50 years after exposure to asbestos. Because mesothelioma presents few symptoms until it reaches an advanced stage, the large majority of patients are given less than a year to live.

In this study, 14 of the 28 patients studied received a traditional course of mesothelioma treatment. Because the malignant cells can envelope the entire lung, the traditional EPP method of treatment involves a combination of lung removal, chemotherapy and radiation. After treatment, this group had an average survival rate of 8.4 months, which is consistent with historical results from this type of treatment. The results of the PDT group, however, surprised researchers.

The 14 patients who received the alternative treatment underwent a less extensive “lung sparing” surgical procedure, which involved the removal of a limited amount of lung tissue. This procedure was combined with PDT, which uses light both to diminish the disease and to stimulate the immune system. PDT, which stops at the tissue itself, is also much less invasive than radiation, which penetrates the entire body. The results of this approach far exceeded the expectations of researchers. In fact, two years after the study began, the median survival rate of this group of patients has not been reached.

The Penn Mesothelioma and Pleural Program continues to study these and other methods, offering a truly multidisciplinary approach to the study of mesothelioma, mesothelioma treatment and mesothelioma therapy.

 

Pneumonectomy and Extrapleural Pneumonectomy

Wednesday, June 1st, 2011

Mesothelioma is a form of cancer affecting the membrane that covers and protects various internal organs of the body (mesothelium). The mesothelium comprises two layers of particular cells known as mesothelial cells. One layer directly surrounds an organ forming a protective sac, while the other lines body cavities, providing oil like lubrication within the body. The most common type of mesothelioma cancer affects the membrane, or sac, lining the lungs (pleura). Other, less common areas include the membrane of the stomach (peritoneum) and the membrane lining the heart (pericardium).

A pneumonectomy is a surgical removal of an entire lung and is used as a cancer treatment. Pneumonectomy may fall into one of two categories: traditional pneumonectomy, resulting in the removal of the diseased lung and extrapleural pneumonectomy, involving removal of the diseased lung as well as areas of the diaphragm and other tissues.

Extrapleural pneumonectomy is typically determined as a surgery of last resort with a goal of eradicating a majority of the cancer cells. Surgeons usually only perform this type of surgery on patients who are in the early stages of mesothelioma cancer, before the cancer has a chance to metastasize, spreading to lymph nodes or invading surrounding tissues and organs. Extrapleural pneumonectomy surgery candidates typically need to be in relatively good health — with good lung and heart function — because removal of an entire lung will increase strain on the heart and remaining lung. They also usually need to be strong and healthy enough to withstand the demands of major surgery and the healing it will require.

In some cases, diagnosis of mesothelioma cancer does not occur until a patient reaches a critical Stage 3 or 4, reducing the chances for this type of treatment. For those who are eligible, extrapleural pneumonectomy may slow or halt the progression of the disease, help ease breathing and improve quality of life. Extrapleural pneumonectomy patients treated with a combination of extrapleural pneumonectomy, radiation and chemotherapy may experience increased life spans of months or, in some cases, years.

 

Pleurectomy Decortication Surgery

Thursday, May 26th, 2011

Mesothelioma was once a rare form of cancer but has become more commonplace today. Some instances of mesothelioma may result from exposure to asbestos fibers that becoming lodged in the thin membrane that lines and encases the lungs. There are various forms of treatment for mesothelioma, and the use of certain types of surgery along with chemotherapy and radiation can treat the symptoms with varying degrees of success.  Pleurectomy-Decortication (PD) is one such surgery, usually done on patients in the earliest stages of mesothelioma, when tissue infiltration is still relatively contained within a smaller surface area.

Pleurectomy-Decortication (PD) is a class of mesothelioma surgery in which the surgeon removes a tumor and/or the lining of the lungs. PD is not a cure, but it may help improve the patient’s quality of life and ease pain resulting from the cancer. The medical community does generally consider PD a radical surgery due to the extensive amount of tissue resection and the highly invasive techniques necessary to complete the operation. However, the surgery may successfully extend survival time in mesothelioma patients.

In PD, the surgeon makes an incision in the chest to reach the pleural cavity, providing access to the lungs and then performs the decortications of the lung and full resection of the visceral pleura. This involves removal of the surface layer of the visceral pleura and some other tissue to try to eradicate all malignant tissue. Following the decortication, the surgeon will likely do whatever reconstructive processes are necessary to ensure proper lung function. During the procedure the doctor also may remove adjacent lymph nodes to be sent to a pathologist for analysis, after which the doctors will decide what follow-up treatments might be helpful.

Once the surgery is performed, the patient will likely need to spend time in the intensive care unit before starting rehabilitation. It is important for the patient to realize this is major surgery with significant post-operative healing, so it will take time to recover.

Pleurectomy-Decortication surgery and other mesothelioma treatments can sometimes be uncomfortable and quite extensive. Yet, it may help patients to remember that, with these surgical options and other selected treatments, medical professionals seek to do everything possible to make a positive impact on the patient’s overall health and quality of life.

 

Palliative Surgery: Thoracentesis

Friday, May 20th, 2011

In medicine, doctors know that the more the patient learns about a surgical process, the less fear the patient has going into the procedure. This may also lead to faster and easier patient recovery. While no known cure for mesothelioma cancer exists, surgery may help alleviate some of the pain and complications resulting from this vicious disease. When the patient understands these surgeries, he or she may feel less fear and more in control.

Last week, we gave a summary of mesothelioma surgeries that a person diagnosed with mesothelioma might undergo. We explained that some mesothelioma patients experience difficulty breathing due to an excess build-up of fluid around the lungs or abdominal area. This can squeeze the lungs, making breathing uncomfortable, even painful. So today, we want to talk about possible, palliative solutions.

Palliative surgeries may help remove and alleviate some of the pain associated with mesothelioma cancer. Thoracentesis is one type of palliative surgery that drains excess fluid from the space between the lung and the pleura (lung lining). A tube is inserted into the chest and used to remove the fluid. The most common type of palliative surgery is Pleurodesis, which seeks to eliminate fluid from the pleural space so fluid cannot continue to collect. First, doctors must remove all the fluid in the pleural cavity. In the Pleurodesis procedure, doctors cause an inflammation in the area that serves to seal the pleural space. Inflammation can be achieved chemically with talc, bleomycin, tetracycline or povidone iodine. It can also be achieved surgically by irritating the pleura with a rough pad to cause the inflammation. In both types—chemically or surgically—the layers are then brought together so they can fuse and future fluid retention can be eliminated.

After recovery, the patient could experience a marked difference in his or her ability to breathe and a lessening of the cough often associated with mesothelioma. While these palliative surgeries are not cures for mesothelioma, they might help the patient feel more comfortable and lead a more productive life.

 

Pleurodesis and Pleurectomy

Tuesday, May 10th, 2011

In the last few weeks, we’ve discussed some basic information on what cancer is and various treatment options specific to mesothelioma cancer patients. In addition to radiation and chemotherapy, surgery is a potential treatment option for this aggressive form of cancer that could possibly result from exposure to asbestos materials. Surgical treatment for mesothelioma may involve different methods or procedures depending on the specifics of the diagnosis.

While there is no known cure for mesothelioma cancer, sometimes surgery may help alleviate some of the pain and complications resulting from this vicious disease. For example, certain patients experience difficulty breathing due to excess build up of fluid around the lungs or abdominal area. Excess fluid build-up can squeeze the lungs, making breathing uncomfortable and even painful.

Palliative type surgeries aim to relieve mesothelioma symptoms by draining the excess fluid. Pleurodesis is another type of surgery in which talc, a mineral silicate, is inserted into the small lining that cushions the lungs in order to help mitigate fluid collection over the long-term.

A pleurectomy is a class of mesothelioma surgery where the surgeon removes a tumor and/or the lining of the lungs. This kind of surgery sometimes accompanies radiation or chemotherapy to help control remaining cancerous tissues. Pleurectomy is not a cure; however, it may help improve the patient’s quality of life and easing pain. Another type of surgery is pneumonectomy, which involves removing the lung, the lining around it and some of the support tissues. This surgery typically occurs with the most drastic cancer cases in an attempt to relieve the pain and discomfort associated with mesothelioma.

Surgery and other treatments for mesothelioma can sometimes be uncomfortable and quite extensive. With these surgical options and other selected treatments, medical professionals seek to do everything possible to make a positive impact on the patient’s overall health and quality of life.

 

Mesothelioma Tumor Grade

Tuesday, November 23rd, 2010

Recent findings about the survival rate of victims suffering from mesothelioma have recently been published, according to a mesothelioma report found on SurvivingMesothelioma.com.  Though the news, unlike many studies and findings recounted in this space, doesn’t directly point toward a new treatment method or combination of approaches for mesothelioma treatment, it does represent an increased level of understanding of how the cancer responds to certain treatments.

The report suggests that victims of malignant pleural mesothelioma were more likely to survive after a diagnosis if they received cancer-directed surgery as part of mesothelioma treatment efforts.  Another important factor is the “grade” of the tumor cells.  The grade refers to its similarity to nearby cells.  According to the report, it appears that the more similar a cancer cell is to its surrounding cells, the higher the survival rate of those afflicted with the disease.

This is good news, and not just because the results of this study might show that patients receiving certain treatments may have higher rates of survival than others.  This is also good news because it means there are signs of progress of a sort within the field of mesothelioma treatment, an area of study that doesn’t quite attract the level of investment as other battles against more common forms of cancer.  Part of that research disparity might be due to the rarity of mesothelioma; after all, only somewhere between seven and 40 people per million in the United States contract the disease, compared to much higher rates for other, more common forms of cancer.

Just because it’s rare, however, doesn’t mean mesothelioma treatment shouldn’t be a concern.  After all, mesothelioma is an aggressive and lethal disease, and though there are treatments for it, there is, unfortunately, no cure.  The survival rate of patients suffering from mesothelioma is often measured in mere months.

Pleurectomy and Pneumonectomy Surgery

Wednesday, October 27th, 2010

There are a couple mesothelioma surgery options available to many who are afflicted with the cancer.  There’s a helpful mesothelioma surgery article on Asbestos.com that does a good job of explaining the difference between the two procedures.

Culled from an article that originally appeared in the New York Daily News, Dr. Raja Flores delineates the two procedures available for patients with pleural mesothelioma.  The two surgical options are a pneumonectomy, which involves removal of the lung with mesothelioma in it, and a pleurectomy (or decortications), which does not.

The goal of most surgeries is to provide the patient with the best possible outcome.  Pneumonectomies are more drastic than pleurectomies, but opting for one over the other depends on a host of factors beyond simple invasiveness.  The location, size, and mass of the tumors all play into a surgeon’s decision to go with one selection over another.  Oftentimes, according to Dr. Flores, a surgeon might not even know which route he chooses to take until surgery is already underway.  That’s because seeing the patient’s condition in-person often provides clues as to the state of the lungs that imaging scans or tests, such as a CT scan, may not provide.

Overall, most doctors want a surgery to be successful.  In the case of surgeries as a treatment option of mesothelioma, a successful surgery might mean an increased quality of life for the patient or a longer life expectancy.

Whatever the outcome may be, surgery can be an invasive and potentially risky procedure.  These facts may factor into why it’s not a universally lauded option when it comes to mesothelioma treatment.  Indeed, some doctors tend to favor options other than surgery as a best option for treatment.  As with many things regarding this disease, there is no consensus on the best route to take.