Surgery for mesothelioma

In the uncommon situation where the cancer is only in one area of the pleura (localised), surgery can be used to treat mesothelioma. It may involve removing part, or all, of the pleura and the lung tissue close to it. This is known as pleurectomy. Sometimes the pleura, diaphragm, and the whole lung on the affected side are removed as well as the tumour. This operation is known as extra-pleural pneumonectomy.

At present it is not clear whether surgery can give better control of symptoms or can help people to live for longer than just using active symptom control. A research trial is currently looking at whether extra-pleural pneumonectomy can give a better quality and length of life for people with localised pleural mesothelioma. This trial is called the MARS trial. You may be invited to take part if your doctor thinks that surgery could possibly be helpful for you.

It is not usually possible to surgically remove abdominal (peritoneal) mesothelioma. If surgery is possible, it is carried out by surgeons with specialist expertise in treating mesothelioma. However, the operation is not likely to cure the mesothelioma.

It is important that you discuss any operation fully with your doctor beforehand so that you understand what it involves. Remember, no operation or procedure will be done without your consent.

Surgery may sometimes be combined with radiotherapy or chemotherapy.

After your operation

It can take many weeks to recover fully from a lung operation, although some people recover more quickly than others. There are things you can do to help speed up your recovery. After your operation, you will be encouraged to start moving about as soon as possible. Even if you have to stay in bed, the nurses will encourage you to do regular leg movements to help to prevent blood clots developing in your legs. A physiotherapist will visit you on the ward to help you with breathing exercises.

Drips and drains

A drip (intravenous infusion) will be used to give you fluids for a couple of days, until you are able to eat and drink normally again. You will also have drainage tubes in your wound. These are usually removed about 2–7 days after your operation depending on your recovery. X-rays will be taken regularly to make sure your lung is working properly.

Pain

It is normal to have some pain or discomfort after your operation. This can usually be controlled using painkilling drugs. Let your doctor or one of the nurses know if you have any pain so they can treat it as soon as possible. Mild discomfort or pain in your chest can last for several weeks and you will be given some painkilling tablets to take home with you.

Going home

You can usually go home after about seven days after a pleurectomy. If you have an extra-pleural pneumonectomy it will probably be about 14 days before you are ready to go home. If you think you might have problems when you go home – for example, if you live alone or have several flights of stairs to climb – let one of the nurses or the hospital social worker know when you are admitted to the ward, so that help can be arranged.

When you go home, it is important to exercise gently, to build up your strength and fitness. Walking and swimming are suitable for most people after surgery to the lung area. But it is a good idea to check with your doctor or physiotherapist which kind of exercise would be suitable for you.