In his own words: Dr. Cameron describes the benefit of Pleurectomy/Decortication (PD) surgery over Extra-Pleural Pneumonectomy (EPP) surgery

Much debate and research exists regarding these two methods of surgical resection in treating mesothelioma. Because no randomized clinical studies have been conducted to compare P/D to EPP, much of the survival data, quality of life issues, even the techniques behind the surgeries remain unproven. Dr. Robert Cameron favors sparing the lung utilizing the Pleurectomy with Decortication surgery. He tells us why: 

 

“When performing surgery for malignant pleural mesothelioma, no matter how meticulous a surgeon might be, they will never be able to completely resect (remove) every last cancer cell — that is impossible. They are going to leave tumor cells in the chest no matter what they do.  Proponents of the radical, highly invasive EPP surgery want to tell a patient they ‘got it all’,  but in fact, that is never the case, and removing a vital organ (a lung) underneath the tumor that has nothing to do with getting all the tumor out is sacrificing vital function that greatly increases the risks of the operation.  Sacrificing vital function of a lung increases the risk of dying during the surgery and increases the risk of complications later on. Why cause problems where there are no problems already?  My philosophy has always been: ‘do no harm.’  Taking out a lung does harm and there is absolutely no benefit to the patient.

 

Another advantage of P/D over EPP is that P/D allows you to limit the operation site to the areas of tumor. By performing EPP, your surgeon may expand your surgery into new places where there is no tumor, and that will just spread the tumor.  In P/D, we leave barriers up (diaphragm, pericardium, chest wall) between tumors and other areas so we don’t spread it.

 

Doing a bigger operation makes no sense from an oncology standpoint, because a surgeon cannot rid a mesothelioma patient of every last cancer cell and cure them – that won’t happen.  Once you accept that, then you can understand why P/D is the best surgical option with the least side effects, the least chance of dying and a better chance of getting as much tumor clearance as possible.” 

 

 

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