Mesothelioma Patients Who Live Longest Usually Undergo Surgery, Mt. Sinai Doctor Says

Dr. Raja Flores, chief of Thoracic Surgery at Mount Sinai Medical Center in New York, says that mesothelioma patients who survive the longest typically undergo some type of mesothelioma cancer treatment, but not necessarily the most radical procedures. Mesothelioma is an aggressive cancer caused by inhaling asbestos fibers.

In a 2012 video, Dr. Flores said Mt. Sinai doctors focus on performing lung-sparing surgery on mesothelioma patients whenever possible. They aim to remove cancerous tissue while leaving the patient’s lung intact. The most common lung-sparing surgical procedure for mesothelioma patients is known as a pleurectomy decortication. It involves removal of the diseased lining of the lung.

Dr. Flores says mesothelioma tumors typically appear first on the outer lining of the lung, then spread into the inner lining and the lung itself, as well as the diaphragm and lining of the heart. In more advanced cases, malignant mesothelioma cells spread to the lymph nodes nearest the tumor and then spread to nodes farther away.

Dr. Flores said the best predictors of a mesothelioma patient’s prospects for survival  are two things: whether the cancer has spread into the lymph nodes and what type of mesothelioma a patient has.

There are three types of cell structures that mesothelioma has —epithelioid, sarcomatoid and mixed. Patients diagnosed with epithelioid mesothelioma have the best prospects, while those with sarcomatoid mesothelioima have the worst survival prospects.

An expert on mesothelioma, Dr. Flores led a landmark study comparing outcomes for mesothelioma patients that underwent radical surgery involving lung removal and lung-sparing surgeries. The study has been influential in changing the surgical management of the disease.

Dr. Flores said the mesothelioma patients who have undergone surgery theoretically have some microscopic cancer cells remaining, so they are treated with radiation and chemotherapy.

Approximately 2,500 to 3,000 people are diagnosed with mesothelioma each year in the United States. Because the disease takes decades to appear after exposure to asbestos, people diagnosed with mesothelioma are typically older workers, retired workers and veterans who were exposed to asbestos in a workplace or in the military decades ago.