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Highly Invasive Mesothelioma Surgery Suspected to Have Low Efficacy

Asbestos diseases are illnesses that develop as a result of prolonged asbestos exposure. Asbestosis for example is a chronic inflammatory and fibrotic medical condition that affects the tissue of the lungs in case asbestos fibers are inhaled. It is regarded as an occupational disease and it significantly increases risks for malignancies such as mesothelioma.

Mesothelioma cancer is a rare, but presently incurable disease, which once it starts spreading, it can metastasize into the lungs and other parts of the chest cavity. Since symptoms appear after years and life expectancy after diagnosis is relatively short (often below one year), conventional treatment which consists of radiation, chemotherapy and surgery, often needs to be radical and aggressive. Surgery used on its own, has shown disappointing results. A pleurectomy/decortication is the most common surgery, in which the lining of the chest is removed.

Another common intervention is an EPP (an extra pleural pneumonectomy), in which the cancerous lung lining, the membranes around other organs of the chest, the hemi-diaphragm and the pericardium are removed. Studies conducted on the life quality and life expectancy after an EEP showed worrying results which make this surgical procedure a controversial treatment of early-stage mesothelioma.

An Italian team of surgeons published a study in the journal Lung Cancer where they even call EPP a harmful procedure. A recent study from England has observed that EPP patients are at risk to develop major complications while still in the hospital with even death occurring in some cases and post-operative life quality remaining significantly lower compared to patients who undergo lung-sparing surgery. As these results have been observed in a small number of mesothelioma centers, it is possible that other centers have more encouraging results in their use of EPP in mesothelioma treatment.