The side effects of mesothelioma surgery depend on the aggressiveness of the procedure and other factors. Potential side effects include infection, pain, organ damage, bleeding, blood clots, cardiovascular complications, and respiratory effects. It is important to weigh the risks of surgery against the potential benefits before making decisions regarding your treatment options.
Bleeding and Blood Clots
Patients usually lose blood during surgery. Blood loss is mostly incidental and does not affect normal body function; however, excessive bleeding can occur when a surgeon accidentally cuts a blood vessel.
Severe bleeding can also occur if cuts are not fully closed during the procedure or new bleeding begins after surgery. If severe bleeding occurs after surgery, the surgeon may have to go back in to stop the bleeding properly. If the patient loses a significant amount of blood, a transfusion may be necessary.
Another possible complication is the formation of a blood clot. This can develop in the lungs, called a pulmonary embolism, or in the legs, called a deep vein thrombosis (DVT).
Blood clots occur because patients are unable to move much after surgery. Inactivity can cause clots to form. Blood clots are dangerous because they can migrate to the lungs, heart, or brain. Blocked blood flow in these areas can cause a heart attack, stroke, or pulmonary embolism, all of which can be fatal.
Doctors may prescribe blood thinners after surgery as a preventive measure. Compression stockings are also useful in preventing clot formation.
Pain is also a common side effect of mesothelioma surgery. Although this side effect is not fatal, it can have a serious impact on quality of life.
Most commonly, pain originates at the incision site and may not recede for some time after surgery. Some pain may never go away completely.
Opioid medications are used to control pain after surgery, which can help the patient take deep breaths and ambulate. Opioids do have potential side effects and risks such as drowsiness, constipation, and could be habit-forming when used for long periods.
Surgery also comes with the risk of infection, which can be deadly if not properly treated. Infection may begin at the incision site with symptoms like swelling, pus, and drainage.
It is generally not problematic when these symptoms are mild; however, if these symptoms are severe or persistent, it can indicate a more serious infection that requires long-term antibiotics.
Deeper infections beyond the incision site can also be serious, difficult to treat, and potentially deadly. These may require additional surgery or invasive procedures to help remove the infection.
General anesthesia also causes side effects. These side effects commonly include:
- Muscle aches
- Sore throat
These side effects are not serious and usually subside as the anesthesia wears off.
Rare but serious side effects include delirium, cognitive problems, and malignant hyperthermia. The latter is a rare but potentially fatal reaction to anesthesia that causes a fever to develop rapidly along with muscle contractions.
Surgeries for pleural or pericardial mesothelioma take place close to the heart. Because of this location, cardiac complications are specific risks for these procedures.
One of the most common side effects is arrhythmia, or an irregular heartbeat. Other possible side effects include heart attack and fluid buildup around the heart resulting in compression of the heart.
Respiratory Side Effects
Respiratory side effects are specific to surgeries used to treat pleural mesothelioma. This is because these procedures involve removing organs and tissues from the lungs or around the lungs.
Pleural effusion, a buildup of fluid around the lungs, may occur after surgical treatments for pleural mesothelioma. Blood, pus, or lymphatic fluid may also accumulate in this space, causing breathing difficulties.
Pneumonia is common since taking deep breaths, coughing, and early ambulation can be difficult after such a large operation. Respiratory failure is also a rare but serious side effect.
Organs near surgical sites may be accidentally damaged during these procedures. For example, the surgeon could accidentally puncture a lung during a procedure in the chest cavity, leading to a collapsed lung.
During surgery for peritoneal mesothelioma, there is a possibility that the bowels, bladder, stomach, or other organs in the abdominal cavity could be damaged.
Lower-Risk Mesothelioma Surgeries
The risk of side effects during mesothelioma surgery depends on the actual procedure. Some procedures come with a low risk of side effects or complications.
These include surgeries to drain fluid from around the lungs, heart, or abdomen. To conduct these procedures, the surgeon only inserts a needle or thin tube to draw fluid. General anesthesia is not usually needed, and the risk of side effects is minimal.
Other procedures carry more of a risk because they are more invasive and require general anesthesia. These procedures include thoracoscopy and peritonectomy.
A thoracoscopy is a minimally invasive procedure that uses small incisions and tools to conduct surgery in the chest cavity. A peritonectomy is a procedure to remove the lining of the abdominal cavity.
Some patients with mesothelioma will undergo more radical procedures to try to cure the disease or extend life expectancy. For example, a thoracotomy is a large incision that allows the surgeon to open up the chest cavity.
A pleurectomy/decortication surgery is then conducted to remove as much of the diseased tissue from the pleura, lungs, diaphragm, pericardium, and lymph nodes as possible.
Any procedure that opens the chest cavity and removes tissue has a high risk of complications and side effects. This often requires going to the intensive care unit (ICU) after surgery and may require staying in the hospital for several days.
The Risks of Extrapleural Pneumonectomy
By far, the riskiest and most radical surgery associated with mesothelioma treatment is extrapleural pneumonectomy. This surgery gives some patients with early-stage mesothelioma a chance of remission while extending life expectancy and possibly curing the cancer.
However, this surgery is extremely complex and comes with many risks, including a significant risk of death. Other complications include cardiac problems, bleeding, infections, and fistulas.
Some mesothelioma experts actually believe the surgery is too risky and that the benefits do not outweigh the risks. This complex surgery removes the pleura, diaphragm, and lymph nodes from the affected side of the chest cavity. What makes the surgery so controversial and risky is that it removes an entire lung. Ensure your surgeon has enough experience with the procedure to evaluate you for this option and carry it out safely.
In addition to the risks and side effects associated with other mesothelioma surgeries, this radical surgery can lead to patient death. As much as 15% of these surgeries result in death, a risk higher than with other types of surgery.
Patients who survive may experience long-term breathing complications and severe activity limitations. About one in three patients who have this surgery will experience some type of serious complication or side effect.
Surgery always comes with potential risks and side effects. The more invasive the surgery and the closer it is to organs, the greater the risks. For mesothelioma, some types of surgical procedures come with serious risks. Before undergoing any surgery, it is crucial to understand the potential risks and side effects to weigh the benefits before going through with it.Get Your FREE Mesothelioma Packet
Page Medically Reviewed and Edited by Elliot Wakeam, M.D
Elliot Wakeam, M.D. is a board-certified surgeon who has been recognized for his role in helping to develop the SMART protocol, meaning “surgery for mesothelioma after radiation therapy.” He also focuses on healthcare delivery; strategies for surgeons to help patients recover post-surgery; and new approaches for surgical cancer treatment. Dr. Wakeam earned a Masters of Public Health at Harvard School of Public Health, followed by his medical degree from Jefferson Medical College, where he graduated magna cum laude. Dr. Wakeam is affiliated with numerous renowned medical associations, including the American Association of Thoracic Surgery, the Canadian Association of Thoracic Surgery, and the American College of Surgeons. He is currently an assistant professor in thoracic surgery at the University of Michigan Health System.