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Most Stage I, Some Stage II, III Pleural Mesotheliomas Potentially Resectable, Says ACS

When it comes to treating mesothelioma, there is no one size fits all approach. According to the American Cancer Society (ACS), “the stage (extent) of a mesothelioma is an important factor in determining treatment options. But other factors, such as whether the doctor feels the cancer is resectable (all visible cancer can be removed by surgery), as well as a person’s general health and preferences, also play a role.” In general, however, “most stage I and some stage II and III pleural mesotheliomas are potentially resectable, but there are exceptions.”

For example, the subtype may determine whether a tumor is resectable, as most doctors don’t believe that sarcomatoid tumors are helped by resection. Whether or not a tumor is resectable may also depend on where it is in the body, how far it has grown into nearby tissues, and if the patient is healthy enough to have surgery.

Common surgeries for many patients with resectable pleural mesothelioma include pleurectomy/decortication (P/D) and extrapleural pneumonectomy (EPP). “Surgery is more likely to result in long-term benefit in early stage cancers,” says the ACS, “where there is a better chance that most or all of the cancer can be removed.” Though EPP might offer the best chance to remove the cancer, the operation is complex and extensive and is more likely to result in complications. As such, not all patients can tolerate it.

Some early-stage peritoneal mesothelioma patients might also benefit from surgery that removes as much of the cancer as possible. “This may be combined with heated intraperitoneal chemotherapy (HIPEC),” says the ACS, which often leads to “long remissions” after the treatment. some later-stage cancer patients may benefit from HIPEC, “but the benefits are more likely to last only a short time.”

It is important to note that imaging tests, such as CT scans, are performed before surgery. A surgeon may feel that the cancer is resectable based on the results, only to discover once the operation starts, that not all of the cancer can be removed. “In these cases, the surgeon may switch to a less extensive operation like P/D (which is easier to tolerate) or even stop the surgery altogether if it’s not likely to be helpful.” If this occurs, chemotherapy (the main treatment for unresectable mesotheliomas) would be the next line of treatment.

If you have been diagnosed with mesothelioma, the goals of treatment should be clear to you and your family before starting treatment. Because mesothelioma can be difficult to treat, taking part in a clinical trial of a newer form of treatment may be a reasonable option.



American Cancer Society. American Cancer Society, Inc., 17 Feb. 2016. Web. 19 Dec. 2017.