Pleural mesothelioma is a rare and aggressive form of cancer that affects the lining of the lungs and chest wall. The most common treatment for early-stage pleural mesothelioma is surgery. However, for some patients, surgery may not be an option due to underlying health conditions or other factors. In such cases, alternative treatments may be considered. In this article, we will explore some of the alternatives to pneumonectomy surgery for stage 1 pleural mesothelioma.
Before we dive into the alternatives, it’s important to understand what a pneumonectomy surgery entails. Pneumonectomy is the surgical removal of one entire lung. This procedure is typically reserved for patients with advanced-stage mesothelioma, where the cancer has spread to both lungs or other parts of the body. For early-stage mesothelioma, where the cancer is confined to one lung, a less invasive surgical option, such as a lobectomy or pleurectomy/decortication (P/D), may be recommended.
Lobectomy: A lobectomy is the surgical removal of one lobe of the lung. This procedure is less invasive than a pneumonectomy and is often recommended for early-stage mesothelioma. During a lobectomy, the surgeon removes the affected lobe of the lung along with the lymph nodes and any other tissue that may be affected by the cancer. This procedure is typically performed using minimally invasive techniques, such as video-assisted thoracic surgery (VATS), which involves making small incisions in the chest rather than a large incision.
Pleurectomy/Decortication (P/D): A pleurectomy/decortication (P/D) is a surgical procedure that involves the removal of the pleura, the thin membrane that lines the inside of the chest wall and covers the lungs. This procedure is less invasive than a pneumonectomy and is often recommended for patients with early-stage mesothelioma who are not good candidates for a lobectomy due to the location or extent of their cancer. During a P/D, the surgeon removes the pleura and any visible tumors, but leaves the lung intact.
Radiation Therapy: Radiation therapy is a non-surgical treatment option for mesothelioma that uses high-energy radiation to kill cancer cells. This treatment can be delivered externally or internally. External beam radiation therapy (EBRT) is delivered from outside the body and is typically given over several weeks. Internal radiation therapy, also known as brachytherapy, involves placing radioactive material directly into the tumor. Radiation therapy can be used alone or in combination with surgery and chemotherapy.
Chemotherapy: Chemotherapy is a systemic treatment that uses drugs to kill cancer cells throughout the body. This treatment is typically given intravenously (IV) and can be used alone or in combination with surgery and radiation therapy. Chemotherapy is often used to shrink tumors before surgery or to destroy any remaining cancer cells after surgery.
Immunotherapy: Immunotherapy is a relatively new treatment option for mesothelioma that works by boosting the body’s immune system to fight cancer. This treatment can be delivered intravenously or directly into the tumor. Immunotherapy is typically used in patients with advanced-stage mesothelioma who have not responded to other treatments.
Clinical Trials: Clinical trials are research studies that test new treatments or procedures for mesothelioma. These trials are designed to determine the safety and effectiveness of new treatments and to identify the best ways to use existing treatments. Patients who participate in clinical trials may have access to new treatments that are not yet available to the general public.
In conclusion, there are several alternatives to pneumonectomy surgery for stage 1 pleural mesothelioma. These alternatives include lobectomy, pleurectomy/decortication (P/D), radiation therapy, chemotherapy, immunotherapy, and clinical trials. Each treatment option has its own benefits and risks, and the best treatment option for each patient will depend on several factors, including the location and extent of the cancer, the patient’s overall health, and their personal preferences. It’s important for patients to discuss all of their treatment options with their healthcare team to make an informed decision about their care.