Side Effects of Mesothelioma Surgery
Any kind of surgery comes with the risks of side effects. Especially when the surgery requires general anesthesia, the risks can be significant. The more involved and extensive a surgery, the bigger the incision and the farther into the body the surgeon must go, the greater the risk of side effects. The location in the body where the surgery is being done can also increase the risk of side effects.
With mesothelioma surgery the risks are relatively high. Most surgical treatments for mesothelioma are extensive, invasive, and are conducted near important organs, like the heart, lungs, or bowels. Potential side effects include infections, 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 about treatment.
Bleeding and Blood Clots
Any kind of surgery can cause excessive bleeding or the formation of blood clots. A hemorrhage, or excessive bleeding, may occur when a blood vessel is cut accidentally during surgery or not fully closed after being cut during the procedure. Severe bleeding may occur shortly after surgery and if bad enough may require that the surgeon go back in to stop the bleeding.
Alternatively, surgery can lead to the formation of a blood clot, or deep vein thrombosis. This is a risk because patients are unable to move much after surgery, and inactivity can cause clots to form. Blood clots are very dangerous because if they migrate into the lungs, heart, or brain, they can block blood vessels and cause a heart attack, stroke or pulmonary embolism, all of which can be fatal. This is why many patients must take blood thinners after surgery, to prevent clots from forming
Pain is also a common side effect of mesothelioma surgery, and while it is not a fatal side effect, it can have a serious impact on quality of life. Most commonly, pain comes from the incision site and may not recede for some time after surgery. Painkillers are most often used to control pain after surgery, but these come with risks. Narcotic painkillers also cause side effects and can be habit-forming.
Infection is a very serious risk of any kind of surgery and a side effect that can be deadly if not treated. The infection may begin at the incision site with symptoms like swelling, pus, and drainage. When this is mild it is not problematic, but severe or persistent symptoms can indicate a more serious infection that requires antibiotics to treat. Deeper infections that go beyond the incision site are also possible and can be serious, difficult to treat, and deadly.
General anesthesia causes side effects too, and these commonly include nausea, vomiting, muscle aches, confusion, a sore throat, and shivering and chills. These are not serious and will go away as the anesthesia wears off. More serious, but also rarer, are 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 are conducted close to the heart, which means that cardiac complications are specific risks for these procedures. One of the most common side effects related to the heart is arrhythmia, or the development of an irregular heartbeat. Other possible side effects include a heart attack and a buildup of fluid around the heart and resulting compression of the heart.
Respiratory Side Effects
Respiratory side effects are specific to surgeries used to treat pleural mesothelioma because they involve removing organs and tissues from the lungs or around the lungs. Pleural effusion, a buildup of fluid around the lungs may occur after surgery. Blood, pus, or lymphatic fluid may also accumulate in this space causing breathing difficulties. Rare, but very serious is respiratory failure.
Surgeries used to treat mesothelioma are done around organs that may be accidentally damaged by the surgeon. For example, a lung may be punctured during a procedure in the chest cavity, and this can lead to a collapsed lung. During surgery for peritoneal mesothelioma, there is a possibility that the surgeon may damage the bowels, bladder, stomach, or other organs in the abdominal cavity.
Lower-Risk Mesothelioma Surgeries
The risk of a patient experiencing side effects during mesothelioma surgery depends on the actual procedure. Some come with a low risk of side effects or complications. These include surgeries used to drain fluid from around the lungs, heart, or abdomen. To conduct these procedures, the surgeon only needs to insert a needle or possibly also a thin tube to draw off fluid. General anesthesia is not usually needed and the risk of side effects is minimal.
Other procedures that carry more of a risk because they are more invasive and require general anesthesia include thoracoscopy and peritnoectomy. A thoracosopy is a minimally invasive procedure that allows the surgeon to use a small incision and small 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. A thoracotomy, for instance, is a large incision that allows the surgeon to open up the chest cavity. A pleurectomy/decortication surgery can then be conducted to remove as much of the diseased tissue from the pleura, lungs, diaphragm, pericardium, and lymph nodes as possible. Any time the chest cavity is opened up and tissue is removed, the risks are high.
The Risks of Extrapleural Pneumonectomy
By far the riskiest and most radical surgery associated with mesothelioma treatment is the extrapleural pneumonectomy. This surgery gives some early stage patients the best chance of remission, life expectancy extension, and even curing the cancer. However, this surgery is extremely complex and comes with many risks, including a significant risk of death. Some experts in mesothelioma actually believe that the surgery is too risky and that the benefits to not outweigh the risks. The surgery involves the removal of the pleura, diaphragm, and lymph nodes from the affected side of the chest cavity, but what makes the surgery so controversial and risky is that the entire lung is also removed.
In addition to the risks and side effects associated with other mesothelioma surgeries—bleeding, infection, fluid buildup, blood clots—this type of surgery puts patients at risk for dying. As much as seven percent of these surgeries result in the death of the patient, a risk higher than with other types of surgery. Patients who survive may experience long-term trouble breathing and serious activity limitations because of having only one lung. About one in three patients undergoing this surgery will experience some type of serious complication or side effect.
Surgery always comes with some side effects. The more invasive the surgery and the closer it is to organs, the greater the risks are. For mesothelioma, risks of some types of surgery are high and patients can expect to experience some potentially serious side effects. It is crucial to be aware of what those side effects are, what the risks are, and to be able to balance those against the benefits of surgery before deciding to go through with it.
Page edited by Dave Foster
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