Essential Questions to ask if you or a loved one has been diagnosed with Mesothelioma ***IMPORTANT***

Intraoperative Chemotherapy

Posted on: October 16, 2023 *Updated on: May 27, 2024

Intraoperative chemotherapy is a specialized treatment approach that combines surgical resection of a tumor with localized chemotherapy, often delivered in a heated form, directly to the affected tissue or cavity. This can be particularly useful in treating cancers like pleural and peritoneal mesothelioma that are notoriously difficult to manage with conventional chemotherapy or radiation. The primary aim is to kill microscopic cancer cells that may be left behind after the surgical removal of the visible tumor.

Advantages:

  1. Targeted Treatment: Direct application allows for higher concentrations of chemotherapy agents to be applied to the targeted area, which can be more effective in killing cancer cells.
  2. Reduced Systemic Effects: Because the chemotherapy is localized, it often leads to fewer systemic side effects like nausea or myelosuppression.
  3. Enhanced Efficacy: The use of heated chemotherapy can improve the absorption of the drugs, potentially increasing their efficacy.
  4. Synergistic Effect with Surgery: When combined with aggressive surgical procedures, intraoperative chemotherapy can extend the median survival rates.

Limitations:

  1. Operative Risk: Any surgical procedure comes with its own set of risks, including infection, bleeding, and complications from anesthesia.
  2. Not a Cure: While it may extend life expectancy, it is not typically a curative treatment for mesothelioma, which remains a challenging cancer to treat.
  3. Selection Criteria: Not all patients are candidates for this aggressive form of treatment, usually those with more localized disease are chosen.
  4. Cost and Availability: This is a specialized treatment that may not be available in all medical centers and can be expensive.

Procedures:

  1. Extrapleural Pneumonectomy: This involves the removal of the lung along with part of the diaphragm, the pleura, and other nearby tissues. Intraoperative chemotherapy may be used to bathe the chest cavity after the removal.
  2. Pleurectomy with Decortication: This spares the lung but removes the pleura and any visible tumors. Again, intraoperative chemotherapy can be applied to the chest cavity to kill remaining cancer cells.
  3. Cytoreductive Surgery: For peritoneal mesothelioma, this involves removing as much of the tumor mass from the abdominal cavity as possible. Heated chemotherapy is then used to wash the abdominal area.

Each of these procedures has its own set of risks and benefits, and the choice often depends on a variety of factors like the stage of the disease, overall health of the patient, and the expertise of the surgical team.

Always consult a healthcare provider for diagnosis and treatment of medical conditions.