Surgical Oncologist

Surgical oncology is the branch of oncology which focuses on the surgical management of cancer, more specifically in this case, mesothelioma.  The objection of the surgeries performed is to diagnose, stage, and treat cancer as well as relieve symptoms. Among their many duties, surgical oncologists perform biopsies, resections, reconstructive surgeries, palliative surgeries and more.

Biopsies are the process of removing a sample of cells or tissues to be tested in a lab. The removed tissue or cell is usually studied by a pathologist and then analyzed chemically. In order for a surgical oncologist to determine if a tumor is malignant (severe or getting worse), there are a variety of biopsies that can be performed.  The most common of these procedures are needle aspiration biopsies, a core or incisional biopsy, an excisional biopsy or an open surgical biopsy.  The later require a removal of a large lump or mass of tissue during a surgical procedure.  Often, it will require general anesthesia to perform.

Surgical resection refers to removal of an organ or a lesion by cutting it away from the body of the remainder of the tissue.  Although the benefits from surgical resection for patients with mesothelioma are questionable, it is important to exhaust all options when it comes to patient treatment.  Surgical resection emerged as being significantly associated with longer survival from a survival model in statistics called the Cox proportional hazards model.  This implicates that other factors including tumor stage, smoking history, asbestos exposure, gender, and pain are controlled for. However, since this undermines some of the factors related to mesothelioma, this type of study remains debatable.

Palliative surgery is performed when doctors have decided that a patient’s cancer is incurable.  Palliative surgeries relieve mesothelioma symptoms like pain and other problems associated with mesothelioma but they are not intended to cure the person or even prolong their life. This type of surgery is strictly done to improve the quality of a person’s life and help the patient live as comfortable as possible.

Palliative surgery may ease symptoms commonly associated with mesothelioma such as:

  • Pleurocentesis – this procedure is used to address the build-up of fluid in the pleural area surrounding the lungs. This fluid makes it very painful and hard for a mesothelioma patient to breathe. This outpatient procedure is performed by means of a long, thin needle that is inserted into the pleural space to extract fluid. However not a cure for mesothelioma, a benefit of the procedure allows patients, just hours after the surgery, to go home given the doctor is happy with the outcome of the surgery.
  • Paracentesis – essentially the same as pleurocentesis, this procedure is performed to remove a build-up of fluid that has collected in the abdomen.
  • Pleurodesis – this surgery is a little more serious, and used to stop the build-up of fluid for a longer amount of time. This procedure involves inserting talco into the pleural space. The talc causes inflammation and in turn stops the fluid from collecting often for as long as a few years. Performed under general anesthesia, a patient usually requires a hospital stay of at least 72 hours during which time a chest tube may remain in place in order to drain addition fluids.

Be Involved, Ask Questions!

It is important that the patient and his or her family feel comfortable with their surgical oncologist. It is also good to know that if they ever have any questions, or need further explanation of a surgery, or treatment, their oncologist will be there to help.  Mesothelioma diagnosis is a scary process and whatever aid a doctor can provide a patient and their family with, they will do their best to provide.
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