Surgery
information to the people..
There are minor forms of surgery which the surgeon
may carry out during the VATS procedure which can involve removing some of the
bulk of the tumour. Surgery may also improve some of the symptoms of the
disease. A very major operation which is called an Extra-pleural
Pneumonectomy (EPP) is only suitable for a very select group of patients
with early stage disease and who are physically and mentally able to tolerate
such extensive surgery. The operation involves the removal of the whole affected
lung along with its lining, the lining of the heart and part of the diaphragm.
This operation is only carried out by a limited number of thoracic surgeons in
the world.
Surgery is only suitable for a small number
of people with mesothelioma. The aim of surgery is usually to help with symptoms
and to control the disease rather than to cure it. Operations are only carried out by
specialist chest surgeons who are part of a multidisciplinary team experienced
in the treatment of mesothelioma. Sometimes surgery is combined with
radiotherapy or chemotherapy treatments.
There
are two different types of surgery that may occasionally be used:
Pleurectomy
This involves removing the tumour and part,
or all, of the pleura and the lung tissue close to it. It is used to help stop
the build-up of fluid in the lung and to help with breathlessness and pain.
Pleurectomy can also help a collapsed lung to reinflate with air, which will
help reduce breathlessness. For some people it may be possible to have a
pleurectomy using keyhole surgery. With this type of surgery, only small
openings are made instead of one large cut (incision).
Pleurectomy is only suitable for some
people with mesothelioma. There are other treatments that don’t involve major
surgery, which can be used to control the build-up of
fluid in the lung, breathlessness and pain.
Extrapleural
pnuemonectomy (EPP)
EPP involves a major operation and is
rarely done today. During the operation, the surgeon attempts to remove all or
most of the tumour and the tissues around it. It involves removing the pleura,
diaphragm, the lining of the heart (pericardium) and the whole lung on the
affected side. As EPP involves such major surgery, it’s very risky. More than
half of all people who have this type of surgery have complications, and there’s
no evidence that it helps people live longer. For these reasons, EPP is not
currently recommended as a treatment for mesothelioma. Surgery for peritoneal mesothelioma Surgery is rarely used to treat peritoneal mesothelioma. The aim
of surgery is to remove the tumour from the wall of the tummy (abdomen) and
from nearby organs. This treatment is usually used to help relieve symptoms.
Newer forms of treatment
Because
standard treatments often have limited usefulness against mesothelioma, researchers
are studying other new types of treatment as well.
A newer type of treatment being tested
on mesothelioma is gene therapy, which attempts to add new genes to
cancer cells to make them easier to kill. One approach to gene therapy uses
special viruses that have been modified in the lab. The virus is injected into the
pleural space and infects the mesothelioma cells. When this infection occurs,
the virus injects the desired gene into the cells. In one version of this
approach, the virus carries a gene that helps turn on the immune system to
attack the cancer cells. Early studies of this approach have found it may shrink or
slow the growth of mesothelioma in some people, but more research is needed to
confirm this.
Other new treatments called cancer
vaccines are also aimed at getting the immune system to attack the cancer.
In one approach, immune cells are removed from a patient’s blood and treated in
the lab to get them to react to tumor cells. The immune cells are then given back
to the patient as blood transfusions, where it is hoped they will cause the
body’s immune system to attack the cancer. This approach is now being studied
in clinical trials.
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