Extrapleural Pneumonectomy May Improve Quality of Life for Mesothelioma Patients

Mesothelioma is a deadly form of cancer that affects thousands of people in the United States each year. Though it presents similar symptoms to lung cancer, this disease functions very differently and thus must be treated very differently. Unfortunately there are currently no cures for mesothelioma, only treatments to reduce pain and increase the patients’ quality of life.

Mesothelioma has only one known cause: exposure to asbestos. Asbestos is a dangerous fibrous material that was once wildly used as insulation. When exposed to asbestos, one is at risk of inhaling the dangerous fibers. Unlike many diseases, it may take decades after the initial exposure for symptoms of mesothelioma to manifest. By then, the disease is often in its later stages, increasing the difficulty of treating it.

The existing treatment plans for mesothelioma are based on effective treatments for other forms of cancer. Chemotherapy, radiation therapy, and surgery are often used together as a multimodal treatment. Though they often have some degree of success in slowing the spread of cancer and reducing the suffering of those diagnosed with the disease, they do not currently offer a cure.

New research and developments are constantly being made in hopes of improving these methods to a curative level. Lately, these developments have been offering hope to those patients. Non-traditional therapies are being designed specifically as a treatment for mesothelioma and are being used in conjunction with the traditional therapies, such as new surgical methods.

Surgery, though one of the most physically demanding methods, is beginning to show more promise. Mesothelioma is characterized by cancer cells forming in the mesothelium, the lining around the body’s internal organs, usually near the lungs (called Pleural Mesothelioma). This makes traditional surgical methods difficult and dangerous, especially for those with late stage mesothelioma. However, a surgical procedure known as extrapleural pneumonectomy, or EPP, is beginning to show significant promise.

Extrapleural Pneumonectomy is a radical surgical procedure that involves operating in the chest cavity as a treatment for pleural mesothelioma. The procedure is designed to treat mesothelioma by removing the bodily tissues that are most likely to be affected. This would include the lining around the lung (pleural mesothelium), part of the lining around the heart (pericardium), a portion of the diaphragm, and the diseased lung.

As you may expect, this procedure, like many forms of invasive surgery, is quite dangerous; it has a 60 percent chance of complications. However, if successful, it appears that this surgical procedure can greatly increase the individual’s quality of life while battling the disease.

A recent study in Italy collected and analyzed data from 29 cases where EPP was performed. Sadly, one patient died immediately after surgery, but the other 28 showed signs of improvement. The median survival rate after surgery was 19.5 months with 17 patients still alive after the first year and 10 alive after the second year. Though this may appear grim, the average survival rate for mesothelioma in general is four to 11 months after diagnosis. This disease sadly has a very low life expectancy after diagnosis, even if it is diagnosed early.

Three months following the surgery, the patients were examined in terms of both physical and emotional health through a series of tests. Patients showed improvements in nearly all categories, including mood and activity level. Unfortunately, after approximately 24 months, the remaining patients reported a return of pain and discomfort. Giving mesothelioma patients two years of improved quality of life is a major achievement.

Though the procedure did not offer a complete cure for mesothelioma, it demonstrated a significant increase in quality of life for an extended period. Research has shown that patients who undergo this surgery at an earlier stage of the disease make the best candidates for EPP as the disease has not spread through as much tissue. Future advances in surgical procedures could lead to improvements for EPP.

As new treatment plans are developed and improved, the medical community moves closer to a cure for mesothelioma.