What Is the Best Treatment for Peritoneal Mesothelioma?

[MUSIC PLAYING] I think the best treatment for peritoneal mesothelioma is a combination of HIPEC or the hypothalamic interpersonal chemotherapy as well as what we call a cell reductive procedure. Which includes the peritonectomy procedure. So certainly the patients that do the best have what we call a complete cytoreduction where the disease that we can see in their abdomen is just on the order of 1 to 2 millimeters. And then adding in the HIPEC. I think the combination of those procedures is the best overall treatment and certainly has been shown to have the best long term survival. There certainly are folks that we've found have done a little bit better. There are a couple of different types of peritoneal mesothelioma. There's epitheliod, sarcomatoid and then biphasic which is kind of a mixed histology. Which is basically how the cells look under a microscope. And the folks that have epitheliod tend to do a little bit better. Women tend to do a little bit better long term. The less disease you start with, the more successful we are in surgery and getting you to that sort of magic point of not being able to see anything left before we put in the high back. However, that doesn't mean that we would immediately say no to anybody who didn't sort of fall into that. So we try to assess everybody as a potential candidate even if they have maybe a less favorable histology either a man or they have a little bit higher amount of disease to start with in their abdomen. So a complete cytoreduction in HIPEC treatment from malignant mesothelioma can certainly carry some risk. We don't offer it to people who don't have good performance status. So you have to have pretty good physical reserve in order to take this on to be able to recover and for us to be able to do it safely. But specifically about the risks anytime you make an incision in someone's abdomen. There's a risk of infection either in the wound or in the abdominal cavity. Oftentimes we do have to resect pieces of the bowel not just the peritoneal and that can lead to some infectious problems. Fortunately, most of the time we're able to get the patients through the recovery without those major complications. But if we can sort of keep away from those major complications most of time we can get folks back to their kind of pre surgical functional status in a couple of months. [MUSIC PLAYING]