While surgery is one of the most effective treatments for pleural mesothelioma, the cancer cannot be completely surgically removed because of the way it grows. As a result, some surgical treatment plans for mesothelioma are followed by chemotherapy or radiation therapy. Photodynamic therapy, which uses light energy to destroy cancerous cells, may also be considered as a post-surgical option to promote the death of remaining mesothelioma cells.
In a 2011 study published in the Annals of Thoracic Surgery, researchers at Pennsylvania University’s Penn Medicine found that the combination of a radical pleurectomy (RP) and intraoperative photodynamic therapy (PDT) yielded superior overall survival than the combination of a modified extrapleural pneumonectomy (MEPP) and PDT. Although the patients’ sexes, ages, diagnoses and treatment histories were all similar, the patients who obtained the radical pleurectomy and PDT responded more favorably to treatment.
The median survival rate for the group of patients who received the MEPP was 8.4 months. At a follow-up 2.1 years after the end of treatment, a median survival rate for the patients who received a radical pleurectomy had not yet been reached. The results yielded by the radical pleurectomy and adjuvant (therapy following surgery) PDT were superior to other studies of surgical treatment plans with patients of similar demographics.
New Surgical Approach Gains Popularity
Between 2004 and 2008, during which the participants obtained their mesothelioma treatment, the preferential surgical approach to managing malignant pleural mesothelioma shifted to lung-sparing procedures. Of the last 16 participants to receive treatment, 13 underwent a lung-sparing operation.
Pennsylvania University’s Penn Medicine states that a RP and PDT combination has been shown to reduce the possibility of a recurrence and improve the outcome of mesothelioma patients’ treatment. Penn Medicine cites studies that suggest the immune system can more adequately attack cancer cells that have been treated by PDT.
The Penn Mesothelioma and Pleural Program offers the lung-sparing radical pleurectomy as an alternative to an extrapleural pneumonectomy (EPP). During an EPP, a patient’s lung, pleura, diaphragm and pericardium are removed, often placing the patient at a higher risk for post-operative mortality. This risk may be reduced by the less extreme pleurectomy. Penn Medicine asserts that their patients treated by RP and PDT have displayed “impressive” local control and survival rates.