Looking at the common palliative surgeries for mesothelioma

Palliative surgery may be an option if the tumor has advanced and spread beyond the mesothelium and can not be removed completely, or if you are too ill to withstand the stress of undergoing a major surgery. The goal of this surgery is to relieve or prevent symptoms, as opposed to trying to cure the cancer.

For pleural mesotheliomas, pleurectomy/decortication is the most common type of palliative surgery. But in many cases, this surgery may be stressful for the patient to bear.

Surgical treatment of peritoneal mesothelioma is often done either to help relieve symptoms or to remove the tumor from the wall of the abdomen and other digestive organs. As with pleural mesothelioma, these tumors are often too extensive to remove completely. Similar operations can be done to remove a mesothelioma from the pericardium (the sac around the heart).

Surgery for mesothelioma of the tunica vaginalis testis, which occurs in the groin, is also not usually curative. Most of the time surgery is done because the tumor resembles a hernia. The surgeon attempts to treat a suspected hernia and only realizes the diagnosis after the surgery is begun. This kind of mesothelioma typically can't be removed entirely.

Other palliative procedures

Several less invasive procedures can be used to control some of the symptoms caused by mesotheliomas, especially those due to the buildup of fluid.

Thoracentesis/paracentesis/pericardiocentesis:

In these procedures, a doctor uses a long, hollow needle to drain excess fluid from the pleura{the lining of the lungs} or the peritoneum{the lining of the abdominal cavity}, they can be done to provide relief from symptoms caused by accumulation of fluid, like difficulty in breathing. The major disadvantage of these techniques is that they often need to be repeated.

Pleurodesis:

This procedure may be done to try to prevent fluid from building up in the chest cavity. A small cut is made in the skin of chest wall, and a hollow tube is placed into the chest to remove the fluid. Either talc or a drug such as doxycycline or a chemotherapy drug is then instilled into the chest cavity. This causes the linings of the lung (visceral pleura) and chest wall (parietal pleural) to stick together, sealing the space and preventing further fluid buildup. The tube is generally left in for a day or two to drain any new fluid that might accumulate.

Shunt placement:

This approach may be used if pleurodesis or other techniques are not effective. A shunt is a device that enables fluid to move from one part of the body to another. For example, a pleuro-peritoneal shunt allows fluid in the chest to move into the abdomen, where it is more likely to be absorbed by the body. The shunt is a long, thin, flexible tube with a small pump in the middle. In the operating room, the doctor inserts one end of the shunt into the chest cavity and the other end into the peritoneum. (The pump is placed just under the skin over the ribs.) Once the shunt is in place, the patient uses the pump several times a day to move the fluid from the chest to the abdomen.

Catheter placement:

This is another approach sometimes used to control the buildup of fluid. One end of the catheter (a thin, flexible tube) is placed in the chest or abdomen and the other end is left outside the body. This is done in a doctor's office or hospital. Once in place, the catheter can be attached to a special bottle or other device to drain out the fluid on a regular basis.