Mesothelioma

Extrapleural Pneumonectomy

An extrapleural pneumonectomy removes the cancerous pleural tissue and the lung nearest the diseased area. A highly invasive procedure, an extrapleural pneumonectomy should only be performed on select individuals. Early-stage pleural mesothelioma patients whose tumors can be surgically removed are typically ideal candidates for this mesothelioma surgery.

Because the extrapleural pneumonectomy is a serious procedure, physicians should select their candidates wisely. Each surgeon has the responsibility to inform the patient on the feasibility of the treatment, as well as to perform necessary tests to evaluate the patient's chance at survival and recovery. While a surgeon's personal preference may vary, extrapleural pneumonectomy patients should meet the following criteria:

• Normal heart function
• No significant kidney or liver disease. (This can be indicated by renal and liver function tests.)
• Sufficient lung function to withstand surgery
• Patient's cancer does not infect the diaphragm or heart. In addition, the disease should not involve the chest wall extensively.
• Age

Serious mesothelioma surgeries such as an extrapleural pneumonectomy should not be entered into lightly. If you are thinking about such a procedure, talk to your doctor. He or she will weigh the risks and the benefits to determine whether an extrapleural pneumonectomy is right for you.

After an extrapleural pneumonectomy, the doctor should monitor the patient for a drop in blood pressure, which may result from reconstruction of the pericardium (sac surrounding the heart). If hypotension occurs, immediate follow-up surgery must be performed. The doctor should also ensure the mesothelioma patient's pain is managed during postoperative care. If the pain is not controlled, the remaining lung may collapse.

Receiving chemotherapy and radiation after an extrapleural pneumonectomy can significantly increase a patient's survival time. If successful, early-stage mesothelioma patients can live up to five years following the treatments, compared to the average mesothelioma patient who usually only lives one year after the diagnosis.

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