Many patients who are diagnosed with mesothelioma are given several treatment options including surgery. Often, surgery is the best way to start managing asbestos-related cancers and head towards recovery.
There are many types of surgical options including an extrapleural pneumonectomy that removes a large section of diseased tissue and cytoreductive surgery that pares invasive tumors. All of these surgeries are aimed at allowing the patient a better quality of life.
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What to Expect Before Surgery
The preoperative stage refers to the weeks and days leading up to surgery. Several tests and procedures are performed to determine if the patient is well enough to endure the physical and emotional strain of a surgical procedure.
- Heart and Lung Tests - Doctors want to make sure your lungs and heart are strong enough to withstand the rigors of surgery. A lung function test will measure how well your lungs take in oxygen and process it. Your nurse will also teach you breathing exercises that must be used after surgery. This will ensure you don’t develop dangerous blood clots after the surgery. An echocardiogram will test your heart function to see how strong it is.
- Scope Testing - Many pleural mesothelioma patients are prescribed either a mediastinoscopy or pericardioscopy test. Both use a tube with an eyepiece or camera to view internal organs through an incision. The mediastinoscopy test is used to look into the chest area and take biopsies of area lymph nodes. The pericardioscopy test looks at and tests the skin around the heart.
Day of Surgery
The day of surgery is likely to be a difficult time for the patient and family members. Most patients are required to spend the previous night at the hospital or show up very early on the surgery day. It is important to follow the doctor’s rules about not drinking or eating prior to the surgery. If not, the medical procedure may be canceled.
Before the surgery, many members of your surgical team may visit you in your hospital room. This includes nurses, the anesthesiologist and your surgeon. They may ask many questions about what you have eaten and your general health. You will have an IV placed in either your arm or hand. This allows your medical team to administer necessary medicines quickly. You will be required to change into a medical gown and wear tight-fitting elastic stockings called compression stockings. Also called thrombo-embolism deterrent (TED) hose, these are aimed at preventing swelling and blood clots.
Up to an hour before the procedure, you will be given medication through your IV or in a pill form that will help you relax.
The Operating Room
Patients are typically taken to the operating room while laying down on a stretcher or gurney. Sometimes, family members are allowed to walk alongside the patient until the operating room doors. Because the operating room is a sterile room, family members are not allowed inside.
Once inside the operating room, you will be transferred from the gurney to the operating table. You will likely see many types of equipment and machinery around you. You will be administered additional medication that will make you sleep soundly.
Once the surgery is completed, you will be transferred to a recovery room, where nurses give personalized patient care. Because you have been heavily sedated, you will sleep during much of this period. Family members are typically only allowed in for short periods. Patients remain in the recovery room for several hours.
Surgical Intensive Care Unit (SICU)
The SICU is intended to give patients extended personalized care during this crucial recovery period. Most patients remain in SICU for two to three days following surgery and in the hospital for up to two weeks. While there, nurses will keep a constant watch on the patient’s surgical incisions and bodily functions and administer pain medications as needed.
Tubes, Appliances and Attachments to the Body
There are several types of tubes in place following the surgery. Some will be removed the day after the procedure, while others will remain in place for several days.
- IV Infusion - This is a continuous drip that is connected to the IV with plastic tubing and a hanging bag. These fluids often contain necessary medications such as antibiotics or pain medication. These fluids are also used to keep the patient hydrated.
- Drainage Tubes - Following abdominal surgery, patients often have drainage tubes from the chest and abdominal area. These tubes are attached to suction machines to remove unnecessary fluid accumulation.
- Stomach and Nasal Tubes (Nasogastric Tubes) - There are several types of stomach and nasal tubes. A stomach tube is inserted through the nose and extended into the stomach to provide necessary nutrients and remove excess fluids. A ventilator is used to assist patients with breathing. A nasal cannula or an oxygen mask provides additional oxygen.
- Urinary Catheter - A flexible tube is place through the urethra into the bladder to allow nurses to measure urine output. This will ensure proper kidney function.
- Epidural - A thin tube inserted into the lower back provides pain medication.
Most patients are moved out of the SICU to a regular hospital room for extended care. Once released from the hospital, patients continue their at-home recovery for several weeks.
Cancer Research UK. Before your mesothelioma surgery. Retrieved from http://www.cancerresearchuk.org/cancer-help/type/mesothelioma/treatment/surgery/before-your-mesothelioma-surgery
Macmillan Cancer Support. Surgery. Retrieved from http://www.macmillan.org.uk/Cancerinformation/Cancertypes/Stomach/Treatingstomachcancer/Surgery.aspx#DynamicJumpMenuManager_3_Anchor_6
University of Southern California. Department of Surgery. Thoracic Surgery. Retrieved from http://www.surgery.usc.edu/thoracic/mesothelioma.html