There continues to be no effective theraphy for malignant pleural mesothelioma. Left untreated, the average survival time is between 5 to 13 months. Even with treatment, the common survival is between 6 to 18 months.
According to a study titled Surgical treatment of Malignant Pleural Mesothelioma - A review, published February 2003 in Chest, researchers noted that :
“In general, MPM (malignant pleural mesothelioma) is a disease confined to the pleural cavity for a long time before metastasizing. Therefore, focus on local treatment by some. However, surgery alone results in high recurrence rates, and the survival benefit remains questionable. In recent years, the emphasis has been on surgery combined with adjuvant therapies.”
Pleurodesis is used for management of persistent shotness of breath that results from pleural effusion, which is the excessive accumulation of fluid in the pleura, the layers of tissue that line the lung and chest cavity. The fluid completely drained and an irritating agent is introduced into the pleural space that may cause scar tissue to form and block the space so it introduced in to the pleural space which will cause scar tissue formation to create and block the area so it will not refill with fluid. The mostly used irritant is sterile, asbestos-free talc, administered either as a powder or slurry (talc mixed in fluid). However, if there is a bulky tumor in the pleural space or the lung trapped by a thick visceral pleural (the part of the pleural lining covering the lung) peel of tumor, so can reduce the amount of bulky tumor production.
Pleurectomy, also called decortication, is open surgery in wich the pleura and the sac surrounding the heart are stripped from the top of the lung to the diaphragm. It is considered more effective than talc pleurodesis in lessening the recurrence of fluid buildup. However, it does not increase survival time. According to a report titled “Video-Assisted Thoracoscopic Pleurectomy in the Management of Malignant Pleural Effusion”, published in May 1995, video-assisted thoracoscopic pleurectomy showed better results than open pluroctomy. This less invasive procedure, performed with 3’ long incisions for the insertion camera and instruments. Was used in a group of 19 times study parcipipants ranging in age from 51 to 84 years old. All of them were successfully discharged from the hospital with an average postoperative stay of 5 days. After the average follow-up 12 months., six patients died of their underlying disease. In the remaining 13 patients, two developed fluid buildup again.
Extrapleural pneumonectomy, is a complex surgical procedure involving complete removal of the disease-affected lung together with the pleura, the sac surrounding the heart, the majority of the diaphragm on the affected side and parts of the nerve the control the diphragm’s movement. It permits the application of the higher doses of the radiation because the lung has been removed and may be the only medical procedure that can be used when a trick tumor rind is blocking the pleural space. In spite of this, the procedure is associated with a high incidence of medical ailments and mortality. In study case titled Prevention, early detection, and management of complications after 328 consecutive extrapleural pneumonectomis, published July 2004 in The Journal of Thoracic and Cardiovascular Surgery, several 328 patients, ranging in age from 28 - 77 years old, undergoingextrapleural pneumonectomy between 1980 and 2000 were tracked.
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