Sunday 11 September 2011

Treatment of Malignant Pleural Mesothelioma

The treatment is based on chemotherapy and occasionally radiotherapy for most patients diagnosed with malignant pleural mesothelioma. Chemotherapy involves three-weekly outpatient visits where drugs are injected intravenously over a few hours. Depending on the tolerance and response to treatment, the number of injections (cycles) may vary from two to more than six
For patients with early stage mesothelioma and a good general condition, multimodality therapy is considered. Multimodality therapy includes chemotherapy, radical surgery (extra-pleural pneumonectomy also known as EPP) aiming at removing all the tumour and radiotherapy.
If your fitness or age does not qualify you for an extra-pleural pneumonectomy (EPP) you may still benefit from a pleurectomy/decortication also known as P/D consisting in the surgical removal of the involved pleura, but sparing of the lung. This procedure allows re-expansion of the lung and prevents fluid re-accumulation in the chest cavity, improving thereby the quality of life.
Depending upon the tumour type, stage and the completeness of removal, up to 50% of patients receiving multimodality therapy can live five years and beyond according to very recent publications.
At both London Bridge Hospital and The Harley Street Clinic, our team provides a full service for this condition including radiotherapy, chemotherapy, minimally-invasive surgery (VATS pleural biopsy and talc pleurodesis), and multimodality therapy involving pleurectomy/decortication and extra-pleural pneumonectomy.
Our surgeon has accumulated a large experience with these operations and our anaesthetists and critical care physicians are used to look after patients following these complex procedures.