Surgery is a common way to treat mesothelioma, particularly when the disease is caught in an early stage. Once they identify and locate tumors and other trouble spots, surgeons like to remove all the cancerous tissues they can find. Sometimes, though, infected parts of the body must be treated in other ways.

Doctors assess each patient for what procedures make the most sense. They take into account several factors, including the stage of the disease and the overall health of the patient. Many of the procedures are considered palliative and are followed by chemotherapy or radiation therapy, what doctors call a multimodal treatment approach. 

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Not every surgery is a major surgery, and surgeries also carry different objectives. Some are highly invasive. Others are biopsies. Surgeries fall into three areas: potentially curative, palliative and diagnostic. Here are the differences among them:

Though researchers continue to develop new ways to diagnose and treat mesothelioma, there are a number of techniques that have been on the scene for several decades. One such technique, thoracentesis, was developed in the late 19th century and is still used today.

Thoracentesis, the extraction of fluid from the lungs and the pleura (pleural effusion), can be used for two purposes. The first is as a diagnostic tool. In this procedure, a doctor uses a hollow needle, or cannula, to extract pleural fluid. This procedure helps to determine the causes behind the fluid buildup. The fluid is then examined for certain qualities that may indicate disease. Usually, however, thoracentesis is not sufficient to determine whether or not a person has mesothelioma. A biopsy is typically required as well.

Before performing the test, doctors will first take an x-ray of the chest, which reveals the extent of the problem and allows them to make the best insertion possible. The skin around the insertion will be disinfected and local anesthesia will be injected to numb the pain. The needle is then inserted. This may cause a feeling of pressure, but not pain (with the help of anesthesia). The procedure is often followed by an x-ray to verify the success of the thoracentesis and the amount of fluid removed.

After the fluid is collected from the lung's chest cavity, it is sent to a lab for analysis. There are a number of factors that doctors examine to determine whether mesothelioma is present. These include:

Fluid in the pleural region can indicate a number of concerns other than mesothelioma. Although cancer is a common cause of excess fluid in the chest, the fluid may also indicate lung infection, connective tissue disease, congestive heart failure, cirrhosis, and a number of other conditions.

Thoracentesis may also be used for palliative reasons to treat the uncomfortable and often debilitating symptoms of pleural effusion. Removing the fluid lessens pressure on the chest and lungs, eases pain in those areas, and provides more space for the lungs to expand.

Thoracentesis is not without risk. Some of the complications that may occur include the following:

There are also a number of minor conditions that may develop as a result of the thoracentesis procedure. These include subcutaneous hematoma (slight bruising or bleeding), anxiety, and cough. 

A pneumonectomy is the removal of a lung in order to eradicate a tumor or tumors that may be associated with mesothelioma and other lung diseases. The human species does not need both lungs to survive, but the removal of a lung is a serious procedure and is only performed if cancer doctors believe it will offer the best chance for survival or will greatly reduce the debilitating symptoms of mesothelioma.

Not every mesothelioma patient is a candidate for a pneumonectomy. Doctors will not recommend this procedure for cases where the cancer has already spread to other parts of the body. Surgical candidates must also be in relatively good health for this procedure to be considered. Heart function must be strong and the other lung must be in good working condition as well.

A pneumonectomy is performed under general anesthesia. The doctor will make a long incision (about seven to nine inches) and remove part of the rib to be able to properly view the lungs. The affected lung will be carefully collapsed and the doctors will clamp, cut, and tie off any attached blood vessels, along with the air tube that flows to the cancerous lung. The lung is removed through the incision and the cut tubes and vessels are thoroughly inspected to ensure that nothing is leaking. Also removed with the lung are the pleural linings of the chest, heart, and diaphragm.

Patients will need to breathe with the assistance of a respirator for the first few days after surgery, and drainage tubes will be used to remove fluid buildup. Usually a two-week hospital stay is required and patients often need to travel to a major hospital to find a surgeon who is an expert in this procedure. Full recovery may take as long as two to three months. In addition, the surgery does carry a risk of heart attack, pneumonia, bleeding, and serious infection. Studies show that approximately six to seven of every 100 patients who opt for pneumonectomy surgery die during or shortly after the procedure. If the surgery is successful, it can greatly improve the patient's quality of life while adding several months to their life span. 

The surgical procedure known as pleurodesis is used to treat pleural effusion, the buildup of fluid in the chest cavity between the lungs and their lining, called the pleural space.

Technically, the process of pleurodesis is used to eliminate the pleural space so fluid cannot continue to collect. Doctors perform this procedure by draining the fluid and inserting a talc-like substance that causes inflammation and serves to seal the pleural space.

There are two methods doctors may use to produce this inflammation. Usually, inflammation achieved chemically, but cancer doctors also use a surgical procedure to irritate the tissue. When surgery is performed, it is common for some of the suspicious tissue to be removed as well. 

In the chemical pleurodesis process, the chest is first drained using a tube. Doctors then introduce a chemical into the pleural space. There are a number of chemicals that may be used, but the most common are bleomycin, tetracycline, povidone iodine, and talc. These chemicals remain in the chest for a few hours until the tissue is thoroughly irritated. Doctors then connect a tube to a suction device, which causes the two layers of the pleura to come together and seals the space where fluid once collected. This process takes place during the course of a few days because it takes some time for the fluid to drain thoroughly. During this time, anesthesia and pain medications are administered, but most patients still describe this procedure as quite painful.

The second form of pleurodesis is surgical. This surgery is performed by using either a thoracotomy or thoracoscopy. In both cases, the pleura are irritated with a rough pad, causing inflammation. As in chemical pleurodesis, the layers are then brought together so they can fuse and future fluid retention can be eliminated.

After recovering from the surgery, patients should experience a marked difference in their ability to breathe, and pain and coughing should lessen as well.