Surgery for pleural mesothelioma

Surgery for pleural mesothelioma may be done either to help prevent or relieve symptoms or to try to remove all of the cancer. Unfortunately, these tumors have often spread too far to be removed completely. Sometimes, the surgeon may not be able to tell the full extent of the cancer – and therefore which type of surgery might be best – until the operation has started.

Extrapleural pneumonectomy (EPP): This surgery may offer the best chance to remove all of the cancer, and it is most often used when the surgeon thinks a cure is possible – typically in patients with resectable mesothelioma of the epithelioid type whose cancer has not spread to the lymph nodes.

This is an extensive operation that removes the pleura lining the chest wall, part of the diaphragm, the pericardium (the sac around the heart), nearby lymph nodes, and the whole lung on the side of the tumor. The diaphragm and the pericardium are then reconstructed with man-made materials.

This is a difficult 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 to tolerate this surgery. Several tests must be done beforehand to be sure you are healthy enough for this surgery. Major complications occur in as many as 1 in 3 people who have this operation.