Mesothelioma is an aggressive cancer that is caused by prior exposure to asbestos. There are three main types of mesothelioma:
Malignant Pleural Mesothelioma (MPM) which begins in the lining of the lungs.
Pericardial Mesothelioma which begins in the lining of the heart
Peritoneal Mesothelioma which begins in the lining of the abdomen
Signs of mesothelioma can take up to fifty years to present due to a long latency period between time of exposure and development of symptoms. This, along with the fact that symptoms are not easily identified as mesothelioma, make it so this type of cancer is usually not diagnosed until it has reached Stage III or IV.
For advanced stage mesothelioma, prognosis is poor and treatment options limited. In some cases, surgery can be considered. There is recent controversy over the standardization and definition of operations that are being used to treat mesothelioma.
The most common types of operations are extrapleural pneumonectomy (EPP) and cytoreductive surgery (thoracic maximal cytoreduction). In both procedures, surgeons attempt to remove as much as possible of malignant tissue, however usually can not remove all of it and residual amounts of the disease are left behind.
Recently, variations to standard operations have been explored with more radical types of resection that is similar to but not the same as EPP and Cytoreductive surgery. These types of surgeries have the best success in patients who have early stage mesothelioma, Stage I or II. The more advanced the stage, the lower the median survival rates, even with aggressive operations.
Not all who are diagnosed with mesothelioma can have surgery, and the morbidity rate for those that do remains high. Oncologists argue, however, that this does not mean that there isn’t a role for surgery in the treatment of mesothelioma, and in some cases, leads to much longer survival and higher quality of life. Due to ongoing investigations into new types of or new combinations of operations and treatments, surgical procedures have not yet been defined in a standardized fashion but include many variables.
Butchart, Sugarbaker, and Rusch, among others, are pioneers in this field, and their research must be given significant consideration. Mesothelioma specialists who perform surgeries must be committed to the ongoing efforts to standardize pre-operative selection criteria and surgical terms, interpretations of the procedure itself, and post-operative complications and endpoints.
An international effort to do so would advance and improve the treatment of mesothelioma around the globe. The more information gathered and synthesized, the better able surgeons will be able to recognize which patients would benefit most and which kind of surgical procedure is best.
This entry was posted on Sunday, January 9th, 2011 at 1:59 pm and is filed under Mesothelioma Treatment. You can follow any responses to this entry through the RSS 2.0 feed.
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