Mesothelioma

Mesothelioma is a rare and aggressive cancer that occurs in the thin layer of tissue that covers the majority of the internal organs (mesothelium). This cancer most often affects the tissue that surrounds the lungs (pleura), but it can also affect tissue in the abdomen and around the heart. When diagnosed at an early stage, mesothelioma can possibly be cured by surgical removal. But when this is not possible, surgery can instead help to reduce the signs and symptoms caused by the disease.

The Allegheny Health Network Esophageal Institute is one of only a few medical centers in the country performing a breakthrough mesothelioma therapy known as hyperthermic intraperitoneal chemoperfusion (HIPEC). The procedure involves surgically removing all visible signs of cancer before heated chemotherapy drugs are introduced directly into the chest cavity.

Tests and diagnosis

• Imaging tests: Physicians use a combination of x-ray, MRI, PET, and CT scans to view the entire chest in order to visualize tumors.

• Blood tests are used to look for specific markers such as mesomark, cancer antigen 125 (CA 125), and Fribulin 3, which may indicate the presence of mesothelioma.

• Fine needle biopsy is when a tiny needle is inserted into an area where a tumor is present. A small tissue sample is removed and then analyzed under a microscope to look for cellular changes.

Treatments

• Pneumonectomy includes removing all organs where the mesothelioma has spread. This may include the lung, lymph glands and parts of the diaphragm.

• Pleurectomy involves removing the tumor away from the lungs, ribs, diaphragm, and chest wall while keeping those structures in place. This will not cure the disease, but may relieve symptoms.

• Pleurodesis involves a surgeon inserting a tube or catheter into the chest to drain fluid that has accumulated. The surgeons may also inject medicine into the chest to prevent fluid from returning.

• Hyperthermic intraperitoneal chemoperfusion (HIPEC) is a highly concentrated, heated chemotherapy that is directly into the chest cavity.

• Radiation therapy uses high-energy radiation to shrink tumors and kill cancer cells. Our radiation oncologists use sophisticated technology to accurately locate tumors and then design treatment plans that precisely target specific doses of high-energy radiation toward cancer cells. This pinpoint accuracy ensures that tumors get the most potent dose of radiation while sparing your surrounding healthy tissue and organs.

• Chemotherapy is the use of medicine to kill cancer. It can be given to patients intravenously through a vein in the arm or through an implanted venous catheter, such as mediport, or orally through a pill.

• Immunotherapy is a form of biological therapy designed to stimulate a patient's own immune system to fight cancer. This can be done by engineering certain parts of a person's own immune system to drive the immune system to work harder or smarter to target and destroy cancer cells. Immunotherapy is sometimes used by itself, but it can also be used along with, or after, another type of treatment to boost its effects.

• Targeted therapy uses drugs to block the growth and spread of cancer by interfering with specific molecules involved in tumor growth.

• Adjuvant therapy is a treatment given after surgery to reduce the chance of residual microscopic cancer cells remaining in your body. This may include chemotherapy and/or radiation therapy.

• Neoadjuvant therapy is a treatment given before surgery, including chemotherapy and/or radiation therapy. This may reduce the amount of tumor remaining at the time of surgery, allowing for a more conservative operation.

Contact us

Undiagnosed or no referral

If you have not been formally diagnosed yet, call (412) DOCTORS (412) 362-8677 to see your primary care provider to explore all possible causes of your symptoms. All thoracic procedures require a referral from a provider before scheduling.

Scheduling a procedure

If you have a referral for a thoracic procedure, contact the team at the facility where you want to have the procedure completed: