Nurse Practitioner Anne Rorie's Column!
 |
Anne Rorie |
Many of our patients ask about biopsies. Nurse Practitioner Anne Rorie has put together some useful information on what to do after a patient shows signs and symptoms for mesothelioma.
December 16, 2011. After a patient has demonstrated signs and symptoms of mesothelioma, a biopsy is required to confirm the diagnosis. Patients may initially present with a pleural effusion, which is a collection of fluid around the lung, and have this drained through a procedure called a thoracentesis. This fluid is then examined for the presence of atypical cells, which is a process known as cytology. However, since cytology from pleural fluid through a thoracentesis is a weak diagnostic indicator, a thorascopic biopsy should be performed. Often patients have questions about this procedure. The following are a few important points to consider when obtaining a biopsy.
The biopsy procedure should be performed by a board certified thoracic surgeon, who is experienced in treating mesothelioma and the appropriate biopsy techniques necessary to limit potential spread of the tumor. When the chest is entered surgically, this allows for the tumor to possibly grow into those new incisional areas, a process referred to as seeding. Therefore, limiting the amount of potential exposure is crucial to contain the tumor.
Discuss the biopsy with your surgeon prior to the procedure. A single port thorascopic incision of approximately one centimeter in length along the line of the potential thoracotomy incision used for future surgery should be made. A limited thoracotomy incision or multiple incision sites should not be recommended. In some circumstances, such as the need for a talc pleurodesis, two small incisions can be made. A talc pleurodesis is a procedure used to resolve recurrent pleural effusions.
Also keep in mind that an adequate sample of the pleura is necessary to best ensure that the type of mesothelioma can be accurately determined by the pathologist. The surgeon should obtain multiple biopsies through the same incisional site. As a result the biopsy specimens can better represent the pathologic characteristics of the tumor.
Patients, their family, or their friends are welcome to contact me with any questions in regards to this procedure or any aspect of their Mesothelioma treatment. I am available Monday through Friday by phone or appointment.
Anne Rorie, MSN, NP
(310) 470-8980
10780 Santa Monica Blvd Ste 100
Los Angeles, CA 90025
