Surgical Procedures
While your surgeon and oncology team may have their own way of treating you or your loved one, here are the major surgeries that are often utilized to treat mesothelioma in a candidate for surgical resection.
EXTRAPLEURAL PNEUMONECTOMY (the EPP) & PLEURECTOMY
There are several surgical options for treating mesothelioma, especially the pleural variety which impacts the lungs, specifically the lining around the lungs. Cytoreductive surgery involves surgically removing tumorous growths around the lungs. An extrapleural pneumonectomy (commonly referred to as an “EPP”) involves removing the entire lung and its surrounding lining. Pneumonectomy involves removing one lung with tumors to prevent the spread of the cancer to the other lung. In recent years, the EPP has fallen out of favor with most treating doctors. These days, most thoracic surgeons are performing more Pleurectomy with Decortication procedures. The pleurectomy involves removing the lining of the lung and scraping tumors off the surface of the lung itself. Robotic surgeries may become increasingly popular in the future, with the hope of offering a less invasive procedure for the patient, but with more control and precision for the surgeon.
HYPERTHERMIC INTRAPERITONEAL CHEMOTHERAPY: The HIPEC
For peritoneal mesothelioma, the Hyperthermic Intraperitoneal Chemotherapy procedure (this is commonly referred to as a “HIPEC”) has become the best option for patients who are considered candidates. Despite numerous recent advances in chemotherapy, the overall chance of chemotherapy being curative is still low, and the side effects are difficult for the patient to endure. However, when these cancers are confined to the peritoneal cavity, HIPEC may be the best option. Before HIPEC is administered, the surgeon will remove all visible tumors that can be removed throughout the peritoneal cavity. This is known as cytoreductive surgery. Following cytoreductive surgery, in the operative setting the surgeon will administer the HIPEC treatment. The surgeon uses a heated solution containing chemotherapy and pools it directly in the abdominal area where the tumors were removed – for as long as two hours. This procedure has – in some cases – proven successful at extending the lives of peritoneal mesothelioma patients for a period of years.
The Orchiectomy
The most common form of treatment for testicular mesothelioma is surgery. This procedure, an orchiectomy, entails removing the affected testicle, along with the spermatic cord, and in some cases, nearby lymph nodes may also need to be removed. This surgery can be followed by chemotherapy and/or radiation therapy to eliminate any remaining cancer cells in the testes and prevent their return.