Pneumonectomy

Malignant mesothelioma, a cancer of the pleura (the membrane that lines the lungs), is usually treated in one of three ways: with chemotherapy, radiation, or surgery.  The surgery most often recommended for advanced meso patients is the pneumonectomy, the removal of the diseased lung and sometimes the diaphragm and/or the lining of the lungs or chest wall.

Technically speaking, an extrapleural pneumonectomy is a procedure whereby the entire diseased lung, the pericardium, a portion of the diaphragm, and the parietal pleura is removed from the affected side of the chest cavity.  Most doctors note that this is the best surgery option when the cancer is located in the middle of the lung and also encompasses the veins and pulmonary artery.  Because of its complexity, this surgery is not widely performed but there are doctors located throughout the country that specialize in this procedure.

Pneumonectomy is often considered a last resort surgery and doctors will carefully assess a patient’s overall health before recommending such a procedure.  Patients undergoing a pneumonectomy will, of course, be left with diminished lung capacity after surgery.  Therefore, your oncologist or surgeon will need to determine the health of your remaining lung before the procedure is recommended.  Disease in the remaining lung may result in long-term shortness of breath and difficulty performing everyday activities.

Those who are viable candidates, however, can expect to prolong their life, thanks to this innovative surgery.  David Sugarbaker, MD, Chief of Thoracic Surgery at Boston’s Brigham and Women’s Hospital, and a pioneer in extrapleural pneumonectomy technique, says “we have shown that this type of operation, followed by a program of chemotherapy and radiation treatment, can give a patient who only had months to live, years to live."

After successful surgery, patients should remember to:

• Take advantage of any pulmonary rehabilitation programs available to them
• Avoid smoking
• Maintain a regular exercise program
• Achieve and maintain a healthy weight