Mesothelioma Surgery Improves Quality of Life | News | Loyola Medicine
Friday, June 10, 2016

Mesothelioma Surgery Improves Quality of Life, Loyola Study Finds

MAYWOOD, IL –  Although surgery can prolong the lives of patients with an aggressive type of cancer called malignant pleural mesothelioma, many patients avoid the operation for fear it will degrade their quality of life.
 
But a study led by a Loyola Medicine thoracic surgeon has found just the opposite: Patients who underwent an operation called pleurectomy and decortication (PD) generally reported their quality of life improved after surgery.
 
Wickii Vigneswaran, MD, presented the study during the 2016 annual meeting of the American Society of Clinical Oncology. Dr. Vigneswaran is division director of thoracic surgery and a professor in the department of thoracic and cardiovascular surgery of Loyola University Chicago Stritch School of Medicine.
 
Malignant pleural mesothelioma is caused by environmental factors such as exposure to asbestos as well as a genetic predisposition to the cancer. It develops in the pleura, the thin layer of tissue surrounding the lungs. As the tumor grows, it restricts the lungs, typically causing shortness of breath, fatigue, weight loss and/or chest discomfort and pain. In PD surgery, the pleura is removed. While the procedure cannot cure mesothelioma, it can help control the buildup of fluid, improve breathing and lessen cancer pain.
 
Dr. Vigneswaran and colleagues administered a cancer quality-of-life survey known as the EORTC QLQ-C30 to 114 mesothelioma patients who underwent PD surgery. The median age was 70, with a range of 50 to 88. Prior to surgery, 31 percent of the patients had a performance status score of 0 (fully functional); 65 percent had a performance status score of 1 (able to do light house work or office work); and 4 percent had a performance status of 2 (ambulatory and capable of self-care, but unable to work). Following surgery, all patients were surveyed at 1 month, 4-5 months, 7-8 months and 10-11 months.
 
The quality of life survey measured overall functioning (physical, emotional, cognitive, etc.); general symptoms (fatigue, nausea/vomiting and pain); individual items (shortness of breath, diarrhea, insomnia, constipation and financial difficulties) and overall health.
 
Improved quality of life was observed in the first month after surgery and was maintained at late follow-up in all patients. Quality of life was not adversely affected by surgery at any time in patients who, prior to surgery, had performance status of 1 or 2; a tumor volume greater than 600 ml. or a type of tumor cell called non-epithelioid.
 
“The net benefit of pleurectomy and decortication justifies the procedure in the majority of patients with malignant pleural mesothelioma,” Dr. Vigneswaran concluded.
 
The study is titled “Quality of Life in Patients Undergoing Pleurectomy and Decortication for Malignant Pleural Mesothelioma.” The surgeries were performed by Dr. Vigneswaran at University of Chicago Medicine, where he practiced before recently joining Loyola.

About Loyola Medicine and Trinity Health

Loyola Medicine, a member of Trinity Health, is a quaternary care system based in the western suburbs of Chicago that includes Loyola University Medical Center (LUMC), Gottlieb Memorial Hospital, MacNeal Hospital and convenient locations offering primary and specialty care services from 1,877 physicians throughout Cook, Will and DuPage counties. LUMC is a 547-licensed-bed hospital in Maywood that includes the William G. and Mary A. Ryan Center for Heart & Vascular Medicine, the Cardinal Bernardin Cancer Center, a Level 1 trauma center, Illinois's largest burn center, a certified comprehensive stroke center and a children’s hospital. Having delivered compassionate care for over 50 years, Loyola also trains the next generation of caregivers through its teaching affiliation with Loyola University Chicago’s Stritch School of Medicine and Marcella Niehoff School of Nursing. Gottlieb is a 247-licensed-bed community hospital in Melrose Park with 150 physician offices, an adult day care program, the Gottlieb Center for Fitness, the Loyola Center for Metabolic Surgery and Bariatric Care and the Loyola Cancer Care & Research at the Marjorie G. Weinberg Cancer Center at Melrose Park. MacNeal Hospital is a 374-bed teaching hospital in Berwyn with advanced inpatient and outpatient medical, surgical and psychiatric services, advanced diagnostics and treatments. MacNeal has a 12-bed acute rehabilitation unit, a 25-bed inpatient skilled nursing facility, and a 68-bed behavioral health program and community clinics. MacNeal has provided quality, patient-centered care to the near west suburbs since 1919.

Trinity Health is one of the largest multi-institutional Catholic healthcare systems in the nation, serving diverse communities that include more than 30 million people across 22 states. Trinity Health includes 94 hospitals, as well as 109 continuing care locations that include PACE programs, senior living facilities and home care and hospice services. Its continuing care programs provide nearly 2.5 million visits annually. Based in Livonia, Mich., and with annual operating revenues of $18.3 billion and assets of $26.2 billion, the organization returns $1.1 billion to its communities annually in the form of charity care and other community benefit programs. Trinity employs about 133,000 colleagues, including 7,800 employed physicians and clinicians. Committed to those who are poor and underserved in its communities, Trinity is known for its focus on the country's aging population. As a single, unified ministry, the organization is the innovator of Senior Emergency Departments, the largest not-for-profit provider of home health care services—ranked by number of visits—in the nation, as well as the nation’s leading provider of PACE (Program of All Inclusive Care for the Elderly) based on the number of available programs.