Curative vs. Palliative Surgery
Mesothelioma has a complex growth pattern that makes complete surgical removal a very difficult task, which is why surgery that aims to remove all cancer cells is more accurately described as “potentially curative” rather than “curative”. Part of what makes cancer such a stubborn malady is that it’s very difficult for surgeons to remove all cancer cells, and any cells that are left behind can grow, divide and lead to the cancer’s return. To try and prevent this from happening, the surgeon removes as much tissue as the patient can safely tolerate. More extreme surgeries attempt to remove visible cancerous tissue as well as tissue that is a likely site for metastasis. Not all patients are healthy enough for more invasive mesothelioma surgeries, however, and sometimes the cancer is too widespread to be removed completely. In these instances, “palliative surgery”—or surgery meant to ease cancer symptoms instead of potentially curing the cancer—may be performed. Palliative mesothelioma surgery can extend a patient’s life and improve their quality of life.
Whether surgery is performed for curative or palliative purposes, it is rarely performed in isolation. Surgery is almost always accompanied by the other standard treatments for mesothelioma: chemotherapy and radiation. Neoadjuvant therapy for mesothelioma is chemotherapy or radiation administered to a patient before surgery in order to shrink mesothelioma tumors and make their removal more manageable. Adjuvant therapy is chemotherapy or radiation administered post-surgery to help prevent the recurrence of tumors.