Disagreement over the use of surgery to treat mesothelioma patientsNew York, New York - Raja Flores is a professor and chief of thoracic surgery at Mount Sinai Hospital in New York City, who specializes in cancers of the chest, mostly lung, esophageal cancer and mesothelioma, a rare cancer of the lining of the lungs, heart, chest and abdomen.
Mesothelioma affects approximately 3,000 Americans a year and can cause a slow, painful death. "Asbestos exposure is the No. 1 risk factor," says Dr. Flores. "That refers to naturally occurring minerals present in many industrial products, like cement, textiles and insulation."
Asbestos is dangerous when inhaled or swallowed and exposure is often silent and invisible. "There can be a 20- to 30-year latency, so it's years after they're exposed that they see symptoms," explains Flores.
There are no specific warning signs for mesothelioma, making it very difficult to diagnose, and most patients won't have symptoms until the disease has spread and progressed to stage 3 or 4. "Shortness of breath is a red flag," says Flores. "That's usually from fluid accumulating in the chest, which can also result from a number of benign reasons." Doctors can drain the fluid and often find some cancer cells.
Mesothelioma treatment is usually some combination of surgery, chemotherapy and radiation, but doctors don't have a consensus about whether surgery is necessary. "The two main surgeries are extra-pleural pneumonectomy, which removes the lung, and pleurectomy/decortication, which spares the lung," says Flores. "The goal of surgery is to get rid of tumor bulk and expand the lung while decreasing the pain and gross size of the disease." There is currently no mesothelioma cure.
