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Cytroreductive Surgery for Peritoneal Mesothelioma

Cyto-reductive surgery is a relatively new option for patients with peritoneal mesothelioma. As research into cyto-reductive surgery methods continues it may become an option for other mesothelioma types. Cyto-reductive surgery is usually combined with chemotherapy, so it is considered a multi-modal mesothelioma treatment. When cyto-reductive surgery is successful, it can increase life expectancy to up to 53 months when combined with hyperthermic intraperitoneal chemotherapy (HIPEC), compared to an average life expectancy of 12.5 months with traditional mesothelioma treatments.

Determining Whether Cyto-Reductive Surgery is an Option

A patient may be a candidate for cyto-reductive surgery if the:

  • mesothelioma is in the peritoneum
  • mesothelioma is localized, or has not spread beyond the peritoneum
  • affected areas are not in a part of the body that would make it more dangerous to perform surgery than the possible benefit would support
  • mesothelioma is not obstructing the bowel, liver ducts, or urinary system

Even if doctors believe that cyto-reductive surgery cannot completely remove the asbestos cancer, this procedure can be helpful to relieve symptoms, such as pain and gastrointestinal distress. The patient’s oncologist will make this recommendation based on the progression of the disease, the patient’s history, and the patient’s overall health. These are important considerations for a patient to discuss honestly with their physician.

The Cyto-Reductive Surgery Process

Candidates for cyto-reductive surgery may undergo chemotherapy first, or doctors may recommend that the cyto-reductive surgery take place first, to be followed by chemotherapy. As every patient is an individual, each case of mesothelioma is different, so the flexibility of treatment is an important factor to consider.

If a patient and their oncologist agree that cyto-reductive surgery is the best option for the treatment of mesothelioma, the typical process is as follows:

  • An MRI and/or CT scan is performed to identify the tumor’s location and size.
  • A laparoscopy (a procedure in which a small camera is inserted through a small incision in the abdomen) may be done to confirm the results of the scans.
  • Tissue samples will be taken through the laparoscope and sampled.
  • If chemotherapy is to be done before the procedure, the chemotherapy regimen will begin.

During the surgery, an oncologist removes as much of the mesothelioma tumor as possible through several stages:

  • Peritonectomy, the removal of the tumor and affected tissues.
  • Visceral resection, the removal of affected tissues other than peritoneal tissues.
  • Electroevaporation, in which electricity is used to close off blood vessels and other tissue. This reduces the likelihood of cancer cells being spread, and also destroys cancer cells while making the remaining tissue a less hospitable place for them to grow.

If chemotherapy is to be done after the surgery, the chemotherapy treatment begins immediately afterwards.

The risks of cyto-reductive therapy are similar to those of other major abdominal surgical procedures, and include complications like abscesses (dead tissue that becomes infected), fistulas (abnormal connections between tissues formed post-surgery), and perforations (holes or leaks that lead to medical emergencies).

Cyto-reductive surgery is considered successful when there are no microscopic traces of disease left after the procedure. However, it is not a cure. Though research into this rare form of cancer is continuing, there is no cure for mesothelioma, and treatments are designed to improve a patient’s life expectancy as well as their quality of life, rather than erase the disease. There is not yet a way to turn back the clock on asbestos exposure, the only known cause of mesothelioma, but victims can seek relief through litigation to help pay for their medical needs and the needs of their families. Contact the Law Offices of Clapper, Patti, Schweizer & Mason to discuss your options.