Mesothelioma surgery removes some or, in selected cases, much of the visible cancer affecting the lining of the lung or abdomen. It is not suitable for everyone. Cancer specialists consider the cancer’s location and extent, a person’s overall health, and whether surgery is likely to help as part of a broader treatment plan.
When is mesothelioma surgery considered?
Mesothelioma is a cancer that develops in the thin layer of tissue surrounding certain organs. It most often affects the lining around the lungs, called the pleura, but it can also begin in the lining of the abdomen, called the peritoneum. National cancer guidance describes surgery as an option for selected patients, rather than a standard treatment for every case.
Whether an operation is possible depends on the mesothelioma type, how far it has spread, and whether doctors believe they can remove enough tumor safely. A person’s heart and lung function, other health conditions, and preferences also matter. A surgical team may recommend treatment that does not involve an operation if the cancer is too extensive or the risks outweigh the possible benefit.
Which operations may be used?
Surgery for pleural mesothelioma
Two major operations may be discussed for cancer in the lining around the lung. A pleurectomy and decortication removes the affected lining and visible tumor from around the lung while leaving the lung in place. An extrapleural pneumonectomy is more extensive: it removes the affected lung and surrounding tissue, and may also involve removing parts of the diaphragm and the lining around the heart. Surgeons may reconstruct removed tissue.
Both operations are major procedures. The choice depends on the disease and the patient’s health, and specialists weigh possible cancer control against the effects and risks of surgery. An operation may be combined with chemotherapy or radiation, before or after surgery, depending on the individual treatment plan.
Surgery for peritoneal mesothelioma
For some people with cancer in the abdominal lining, doctors may consider cytoreductive surgery, an operation to remove visible tumor. It may be followed by heated chemotherapy placed directly into the abdomen during surgery, a method called HIPEC. This approach is complex and appropriate only for selected patients at centers with relevant experience.
How doctors decide and prepare
Doctors usually confirm mesothelioma with a biopsy, which means taking a tissue sample for examination. Imaging tests, such as CT scans, help show where the cancer is and whether it has spread. A specialist team reviews the results and assesses whether an operation can be performed and what other treatment may be needed.
Before surgery, the team may check breathing, heart health, nutrition, and ability to recover from a major operation. Patients can ask what the procedure is intended to achieve, what alternatives are available, and how treatment might affect daily activities. A second opinion from a mesothelioma specialist can help clarify options when a major operation is being considered.
Risks, recovery and the role of asbestos exposure
Major surgery can cause complications, including infection, bleeding, blood clots, breathing problems, or changes in how the body functions. Recovery varies with the procedure and the person’s health. Hospital care, pain control, breathing exercises, rehabilitation, and follow up appointments may be part of recovery. The care team can explain which effects are expected and which symptoms need prompt attention.
Asbestos is the established cause of most mesothelioma cases. The disease can appear many years after exposure, and a person may not know when or where exposure happened. Workplace and public health guidance recommends preventing exposure and following proper safety procedures when asbestos containing materials may be disturbed. Avoiding further exposure is important, but it does not treat cancer that has already developed.
Will an operation be part of the treatment plan?
The answer depends on the cancer’s location and spread, the person’s health, and the likely balance of benefit and harm. A specialist team can explain whether surgery is a reasonable option and how it would fit with other care.