Recovery After Surgery for Mesothelioma

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The path to recovery after surgery often is long and challenging, and can be especially difficult for patients recuperating from an aggressive surgery for a cancer such as mesothelioma.

Mesothelioma treatment is a life-changing venture that could improve the length and quality of your life, giving you more time to spend with the people you love.

But these benefits come with many risks and hardships — physical and emotional.

While experts consider surgery the cornerstone of treatment, not every patient qualifies. For those who do, the recovery period can range from six weeks to a year, depending on the procedure.

Chemotherapy and radiation therapy can cause fatigue and other undesirable side effects, but otherwise might not interfere with your job or normal routine. A treatment plan combining surgery and one or more additional therapies is the current gold standard, but this approach may delay recovery.

Before you make treatment decisions based on your doctor’s advice, it’s important to familiarize yourself with each treatment option and the recovery phase that lies ahead.

Timeline for Recovery After Mesothelioma Surgery

For most potentially curative surgeries, a hospital stay of up to two weeks is common. Recovery at home usually is less intensive, but lasts much longer — from eight weeks to as long as a year. Any complications along the way can delay recovery.

Every patient and treatment plan is unique, so no recovery timeline will be exactly alike. The time it takes to recover fully can vary depending on the stage of your cancer, your overall health and the specific course of treatment you decide on.

Here’s a possible timeline for recovery after major cancer surgery:

  • Day 1: After the procedure, you will wake up with many tubes in place. Some deliver painkillers and hydrating fluids to your body, while others drain your wound, stomach fluid and waste. You may need to wear an oxygen mask to help you breathe at first. Pain or discomfort is common after surgery, so your doctors and nurses will work with you to develop an effective pain management plan.
  • The First Week: Pleural mesothelioma patients can typically start eating and drinking again the day after surgery. Peritoneal mesothelioma patients may have to wait longer to give the body more time to recover. When you can eat and drink on your own, a nurse will remove your intravenous (IV) drip. As early as day two, your care team will guide you through deep breathing and gentle leg exercises. After a few days, you’ll be standing up and walking short distances. You won’t be able bathe or shower until your incisions are fully healed.
  • Week 2: If recovery is going well, most patients can return home after one or two weeks in the hospital. You will have to avoid most physical activities for several weeks. After about two weeks, sometimes sooner, you’ll return to the hospital to have your stitches or staples removed. Your drainage tubes will stay in place as long as they continue to drain fluid, which usually lasts longer than one week.
  • Week 3: You may feel more tired than usual and need to rest often, but be sure to maintain an exercise program and continue your breathing exercises. Your care team will provide exercise guidelines and answer any questions about how to care for yourself at home. If you experience any new pain, talk to your doctor about what is causing it.
  • Week 4 – Week 8: It could take between six and eight weeks before your normal energy levels return. You should get a little stronger each day, but avoid overly strenuous activities. You shouldn’t lift anything heavier than 10 pounds for six to eight weeks after open surgery, or about two weeks after minimally invasive surgery. You may be healthy enough to go back to work four to six weeks after surgery, but always check with your doctor first. Sometimes it can take months before patients start feeling back to normal. Be sure to get plenty of rest, and don’t rush your recovery.

Multimodal Therapy Can Prolong Recovery

If you’re healthy enough for mesothelioma surgery, there’s a good chance your doctor will recommend additional treatments before, during or after the procedure. This approach, known as multimodal therapy, currently offers the best hope for long-term survival.

It is important to understand that a combined approach to treatment can affect your recovery time. A multimodal therapy plan that incorporates surgery typically lengthens recovery time, but all patients respond to treatment differently.

Multimodal therapy can include any combination of surgery, chemotherapy and radiation therapy. The length of your recovery will vary depending on the treatments you choose and how your body reacts to them.

Surgery

There are two leading surgeries for pleural mesothelioma: Extrapleural pneumonectomy (EPP) and pleurectomy/decortication (P/D). Full recovery from the aggressive EPP procedure usually takes six to eight weeks, but may extend to three to four months.

Recovery from the lung-sparing P/D procedure ranges from four to six weeks. Patients who received a P/D should expect a hospital stay of about one week, while EPP patients usually stay at least two weeks.

Peritoneal mesothelioma patients often benefit from heated intraperitoneal chemotherapy (HIPEC), a multimodal option that combines surgery and heated chemotherapy. Recovery from this procedure ranges from six months to a year, but it can add years to life expectancy.

Chemotherapy

Doctors may offer chemotherapy before surgery to shrink the tumor before the procedure. After surgery, an ongoing chemotherapy regimen can help prevent the cancer from returning. If the cancer grows or spreads after initial treatment, your doctor may recommend second-line treatment with different drugs.

Side effects can be difficult to manage, so ask your doctor about what to expect and how you can cope. Most patients feel weak or drained after chemotherapy, but the tiredness generally subsides after a few days. Once it passes, you may feel even better than before.

Medication can help with post-treatment nausea and vomiting. There are no treatments to help with hair loss, but your hair will grow back after your last cycle of chemotherapy. Some patients struggle with emotional issues related to hair loss, so wearing a wig or joining a support group may help.

Sometimes chemotherapy requires a hospital stay of a week or more, but many patients can continue to work and lead a mostly normal life throughout treatment. Others may be too tired or energy-deprived to work, but that’s okay. Rest often and focus on recovery.

Radiation Therapy

Like chemotherapy, radiation therapy is an ongoing treatment that can drain your energy and cause fatigue. If you opt for radiation after surgery, the most common side effects include redness, irritation and hair loss around the treatment area. Having chemotherapy before or at the same time as radiation therapy can make the skin reaction worse.

Radiation therapy for mesothelioma typically lasts four to five weeks, with five 30- to 60-minute sessions per week. You will need to schedule regular follow-up appointments with your doctor once treatment ends.

Post-Treatment Physical and Emotional Challenges

It’s difficult for the body to recover from mesothelioma therapy, particularly when surgery is part of your treatment plan. Regardless of the treatments you receive, there likely will be emotional hurdles to overcome as well.

The days following chemotherapy and radiation therapy may feel exhausting, but as long as you have the energy, you should be able to perform normal daily activities. You need to be more careful with physical activity after major surgery, as the recovery process is much longer. A good balance of exercise and rest can help alleviate fatigue from treatment.

If you feel pain during any type of activity, stop immediately. You may want to consider meeting with a physical therapist to help you regain strength.

While you work on your physical recovery, don’t neglect your emotional needs. Cancer treatment is never easy, and it’s perfectly normal to feel a wide range of difficult emotions, including sadness, anxiousness and fear. Studies show many cancer patients can achieve a higher quality of life by joining a support group and sharing their feelings and experiences with others.

If support groups aren’t for you, there are plenty of other outlets that might fit your situation and personality better. You can also seek emotional support from family, friends, online support groups, spiritual groups or one-on-one counseling.

Surviving cancer may be one of the greatest challenges you’ll ever face, but you don’t have to face it alone. It’s not easy to stay upbeat throughout treatment, but a positive attitude and a solid support system can help tremendously on the road to recovery.

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  2. Tsilimparis, N. et al. (2013, January). Quality of Life in Patients after Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy: Is It Worth the Risk? Annals of Surgical Oncology. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/22868919
  3. American Cancer Society. (2014, August 24). Will I Be Able to Work During Chemo Treatment? Retrieved from http://www.cancer.org/treatment/treatmentsandsideeffects/treatmenttypes/chemotherapy/understandingchemotherapyaguideforpatientsandfamilies/understanding-chemotherapy-working-during-treatment
  4. American Cancer Society. (2013, December 19). Lifestyle Changes after Malignant Mesothelioma. Retrieved from http://www.cancer.org/cancer/malignantmesothelioma/detailedguide/malignant-mesothelioma-after-lifestyle-changes
  5. American Cancer Society. (2013, December 19). How Does Having Malignant Mesothelioma Affect Your Emotional Health? Retrieved from http://www.cancer.org/cancer/malignantmesothelioma/detailedguide/malignant-mesothelioma-after-emotional-health
  6. Cancer Research UK. (2013, December 17). Which Surgery for Mesothelioma. Retrieved from http://www.cancerresearchuk.org/about-cancer/type/mesothelioma/treatment/surgery/which-surgery-for-mesothelioma
  7. Cancer Research UK. (2013, December 17). After Your Mesothelioma Surgery. Retrieved from http://www.cancerresearchuk.org/about-cancer/type/mesothelioma/treatment/surgery/after-your-mesothelioma-surgery
  8. Cancer Research UK. (2014, September 29). Radiotherapy for Mesothelioma. Retrieved from http://www.cancerresearchuk.org/about-cancer/type/mesothelioma/treatment/radiotherapy-for-mesothelioma

Joey Rosenberg is a researcher and content writer for The Mesothelioma Center. He is an alumnus of the University of Central Florida with a background in technical writing. Joey joined The Mesothelioma Center in 2011 to raise awareness and understanding of mesothelioma and other asbestos-related diseases. If you have a story idea for Joey, please email him at jrosenberg@asbestos.com.

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