Thoracic Surgeon vs. Surgical Oncologist for Mesothelioma Surgery

Do You See a Thoracic Surgeon or a Surgical Oncologist for Mesothelioma?

The physician performing your surgery is dependent on which type of mesothelioma you have. For pleural mesothelioma in the lining of the lungs, a thoracic surgeon leads the surgery. For peritoneal mesothelioma in the lining of the abdomen, a surgical oncologist leads the surgery.

In both cases, your surgeon will not be making decisions on their own. Your mesothelioma treatment should be led by a team of experienced mesothelioma physicians, including your surgeon.

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Karen Selby, RN and Patient Advocate: The Importance of Seeking a Mesothelioma Specialist

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Because mesothelioma is so extremely rare, we strongly encourage mesothelioma patients to seek out a center of excellence and we are happy to give recommendations of their specialists.

The specialists are on the cutting edge of the new treatments, they they know what’s out there, they know what’s coming and it’s very difficult for a a local oncologist to be as equipped to answer those questions as an expert in the field will be.

So it’s very important. It’s almost a disservice to the the patient to not go to a center of excellence.

The Differences Between a Thoracic Surgeon and Surgical Oncologist

The surgeon you need is determined by where your mesothelioma is, which is set by your diagnosis and cell type. Knowing your type tells you how your surgeon leads your care. What matters most for mesothelioma is that whichever surgeon you see has deep, specific experience with this rare cancer.

A thoracic surgeon and a surgical oncologist are both cancer surgeons, but they specialize in different parts of the body. A thoracic surgeon operates in the chest, including the lungs and their lining, which is why they lead pleural mesothelioma surgery. A surgical oncologist focuses on tumors in the abdomen and other regions, which is why they lead peritoneal mesothelioma surgery.

Thoracic Surgeon vs. Surgical Oncologist

Pleural Mesothelioma

Pleural mesothelioma is the most common type of mesothelioma diagnosis with 80% to 90% of cases. A thoracic surgeon leads the surgery for pleural mesothelioma. The two main operations are pleurectomy and decortication, and extrapleural pneumonectomy.

P/D removes the infected lining of the lung, while EPP removes the entire infected lung. A P/D or EPP is performed depending on how far the disease has spread. P/D removes the diseased lining and spares the lung. EPP is a more extensive operation with the full removal of the diseased lung, adjacent lining, the pericardium and a portion of the diaphragm.

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Andrea Wolf: Introducing Dr Andrea Wolf thoracic surgeon and mesothelioma specialist

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My name’s Andrea Wolf. I’m a thoracic surgeon who specializes in cancer.

Largely in plural mesothelioma and early stage lung cancer. I practice at Mount Sinai. I run the New York mesothelioma program there.

Peritoneal Mesothelioma

A surgical oncologist leads surgery for peritoneal mesothelioma. The most common procedure for peritoneal mesothelioma is a cytoreductive surgery with heated chemotherapy, or HIPEC.

A surgical oncologist will generally perform cytoreductive surgery with chemotherapy or HIPEC to treat peritoneal mesothelioma. CRS is performed when the surgeon carefully removes tumors and signs of illness from the abdomen. This procedure is often followed by HIPEC and chemotherapy treatments to help prevent abdominal tumors.

HIPEC removes visible tumors from the abdomen, followed by heated chemotherapy directly into the abdominal cavity. Chemotherapy with surgery is a common form of multimodal therapy.

Rarer Types

Pericardial and testicular mesothelioma are very rare and surgery is handled by the specialist suited to that location. A mesothelioma team can route you to the right physician and surgery for your circumstances.

Our Patient Advocates can help you find a mesothelioma-specialized surgeon, transfer your medical records, and schedule a consultation. We can match you with doctors and specialists to help navigate your mesothelioma diagnosis.

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Why You Need a Mesothelioma Treatment Team

Choosing between a thoracic surgeon and a surgical oncologist decides who performs surgery, but surgery is only one part of mesothelioma treatment. The best outcomes come from a multidisciplinary team where the surgeon, medical oncologist, radiation oncologist and others plan your care together.

Physicians of a  Mesothelioma Team: 

• Medical oncologist: Directs chemotherapy, immunotherapy, and targeted therapy.
• Pathologist: Confirms the diagnosis and cell type.
• Patient advocate or nurse navigator: Coordinates records, scheduling, and second opinions.
• Pulmonologist and radiologist: Read scans and assess the lungs.
• Radiation oncologist: Plans and delivers radiation.
• Thoracic surgeon or surgical oncologist: Performs surgery based on mesothelioma type.

At a mesothelioma center, these specialists review cases together in a tumor board. Each mesothelioma case has special circumstances that demand close examination from multiple perspectives.

Insight From a Mesothelioma Specialist

“The radiation oncologist will give their input on that specific case. The medical oncologist will chime in. The thoracic surgeon will provide his or her expertise. The pulmonologist, the pathologist who will review the slides, the radiologist… They all work together as a singular team under one roof in the same clinic space.”

Dr. Jacques Fontaine, Thoracic Surgeon

Questions to Ask Your Mesothelioma Surgeon

Whether you see a thoracic surgeon or a surgical oncologist, the single most important factor is their experience with mesothelioma. Mesothelioma is rare, but there are experienced specialists and physicians that can guide you through your mesothelioma treatment.

Questions to Ask Your Mesothelioma Surgeon

• How many mesothelioma cases do you treat each year?
• Do you specialize in pleural or peritoneal mesothelioma specifically?
• Can my case be presented to a mesothelioma tumor board?
• Are you part of a multidisciplinary mesothelioma team or center of excellence?

A second opinion is standard practice for a rare cancer. Dr. Jeffery Velotta, thoracic surgeon and pleural mesothelioma specialist, says, “I really urge you to see mesothelioma surgeon experts, not just a regular thoracic surgeon. Not that a regular thoracic surgeon’s not a good surgeon, it’s that mesothelioma, it matters how many you’ve done.” A Patient Advocate can help you find a mesothelioma-specialized surgeon, transfer records, and schedule faster.

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Common Questions About Mesothelioma Surgeons and Oncologists

What does a thoracic surgeon do?

A thoracic surgeon operates on organs inside the chest, including the lungs, the lining of the lungs, or the pleura, and the chest wall. For mesothelioma, a thoracic surgeon who specializes in the disease leads surgery for pleural mesothelioma, such as a pleurectomy and decortication or an extrapleural pneumonectomy.

What is a surgical oncologist, and what do they treat?

A surgical oncologist is a surgeon with specialized training in removing cancerous tumors. They treat cancers in many parts of the body. For mesothelioma, a surgical oncologist leads surgery for peritoneal mesothelioma, usually cytoreductive surgery with heated chemotherapy.

Can a surgical oncologist give chemotherapy?

Generally, no. Chemotherapy is directed by a medical oncologist. The exception is during peritoneal mesothelioma surgery, when a surgical oncologist delivers heated chemotherapy directly into the abdomen (HIPEC) as part of the operation. Ongoing chemotherapy after surgery is managed by a medical oncologist.

Are thoracic surgeons trained in oncology?

Yes. Thoracic surgeons are trained to operate on cancers of the chest and many work closely with oncologists as part of a cancer team. For a rare cancer like mesothelioma, what matters most is whether a specific thoracic surgeon has deep, ongoing experience treating mesothelioma, not just general thoracic surgery.

Do I need a referral to see a mesothelioma surgeon?

Often, yes. Many specialists and insurance plans require a referral, though some accept self-referrals or second-opinion requests directly. You don’t have to navigate this alone. A patient advocate can help you find a mesothelioma-specialized surgeon, request a second opinion, and gather the records you’ll need.