Surgery is only suitable for some people with pleural mesothelioma. It is usually done to either diagnose the cancer, or to help relieve symptoms.
Surgery to try to cure pleural mesothelioma or help people live longer is called radical surgery. Radical surgery is only possible in a very small number of people. This is mainly because mesothelioma is often found at an advanced stage. Because it is major surgery, you also need to be well enough to have the surgery.
These major operations are done by specialist chest (thoracic) surgeons who are experienced in treating mesothelioma. Sometimes it may be done as part of a clinical trial.
This is when the surgeon removes only the pleura that contains mesothelioma cells. They do not remove any lung tissue. Removing the outer pleura is called a pleurectomy. Removing the inner pleura is called a decortication. Depending on the stage of mesothelioma, you may have both of these operations together. This operation is called a pleurectomy decortication, or PD.
Surgeons sometimes do a smaller operation to remove only some of the pleura (partial pleurectomy). This can help with symptoms, for example to help reduce the build-up of fluid in the pleura (pleural effusion).
It may be possible to have the partial pleurectomy using keyhole surgery (video-assisted thoracoscopy VAT). During this operation, the surgeon makes several small openings instead of one large cut. The other types of surgery are usually performed through one large cut on the side and back of the chest (thoracotomy).
For more advanced mesothelioma, as well as removing the pleura, the surgeon may also have to remove other nearby areas. These can include part of the covering of the heart (pericardium), lung tissue and the muscle between the lung and the abdomen (diaphragm). This is known as an extended pleurectomy decortication (EPD).
If surgery is a suitable treatment for you, your specialist will tell you more about what to expect.
We have more information about treatment for mesothelioma.