Extrapleural Pneumonectomy

If you’re suffering from pleural mesothelioma in its earliest stages, extrapleural pneumonectomy is a surgery that can help treat it.

If you’re suffering from pleural mesothelioma in its earliest stages, extrapleural pneumonectomy is a surgery that can help treat it.

Removal of the afflicted lung allows for the epicenter of the cancerous cells to be taken from the body. Mesothelioma must be caught early for patients to qualify for this surgery. Unfortunately, as patients are typically diagnosed within the later stages there are far more who aren’t eligible than are. 

The purpose of the surgery is to give patients back their preferred standard of living and allow them to return to their normal routines. 

Unlike some other forms of treatment, it is widely believed EPP is far more likely to separate all signs of cancerous cells from the body. Though many other doctors disagree, stating that it is far too old fashioned and offers far more risks than modern treatment options. 

Between 2003 and 2014 a study was conducted of the success of combined modality treatment and EPP as a means for treating pleural mesothelioma. The study concluded that there was a survival rate of five years of twenty-four percent of patients. While it is not a complete success, it has been known to help as a treatment option rather than a cure-all. 

What this combined treatment of EPP and other methods does, is to decelerate the advancement of the cancer. This can help give patients a more comfortable standard of living and ensure they can breathe a bit easier Combined radiation and EPP can even halt the production of the cancer and keep it from returning to the same spot. 

There is no definitive cure-all, but other treatment options instead of or in addition to EPP can help to minimize symptoms and give you and overall better quality of life. Cancer treatments, clinical trials, combined, complementary, and alternative methods, can all be viable treatment options you should discuss with your doctor. They will be able to suggest what they think will be best for your stage of mesothelioma and what they think will give you the best results and chance at life. 

Dangers & Problems

In more recent years it hasn’t come as highly recommended as a form of treatment, as the risks tend to outweigh the rewards. There have been several cases of death while in surgery or after as there is a higher mortality rate than other procedures.

It also does not entirely reduce the chance for a local recurrence of the cancer. 

In a high majority of cases that did not receive radiation therapy after their EPP, there was a resurgence of the cancer locally in more than 75% of cases. If paired with radiation treatment shortly after surgery, the chance of local resurgence drops to just over 10% of cases. Though non-local resurgence happened to be an issue with less than 60% of patients. 

The issues that tend to crop up in the short term with EPP are varied, but they can be concerning. 

  • Fluid or clotting in the lungs
  • Possible heart attack
  • Pneumonia
  • Infectiona at the surgical site
  • Feverishness
  • Chest pains

Serious issues and long-term problems can include prolonged trouble breathing, which may mean the need for oxygen assistance. This can either be temporary or a long-term need depending on the severity of your trouble breathing. 

It can lower your chances of survival by a few months as well so it is important to do your research on your individual candidacy and other options. 

What Does EPP Do?

Before you can even be considered for surgery, doctors must run a series of tests to ensure that your candidacy is valid. Seeing as the procedure entails removing the cancerous lung, the doctor will need to verify that the other lung is healthy and capable enough to work on its own. They also need to ensue that your other organs are healthy enough to withstand such an extensive medical procedure. 

They will also need to check to see if the cancer has spread anywhere else and if so the viability of your candidacy will be deemed invalid.

The operation will not work as described if the cancer has already spread beyond the afflicted lung. 

If you are able to undergo the surgery it will be done under a typical anesthetic. Once you have been put under, the doctor will cut either on the chest or along the side and look for any cancerous tissues. This will usually include the cancerous lung, parts of the lining of both the heart and lung, and any lymph nodes nearby that have been affected. 


Once you’ve undergone your EPP surgery, you’ll want to take it as easy as you can. While this surgery does boast a quality of life improvement, it won’t happen overnight. You’ll need to get plenty of rest and not exert yourself too much as your body will need to adjust to utilizing only one lung. 

There may be a chance that you have to be put on an oxygen tank, respirator, or some other form of breathing apparatus until you have adjusted to the new breathing. Most hospitals will keep you in their facility for at least two weeks for your recovery. They want to ensure that they can catch and hopefully correct any complications, issues with the surgical site, or help you learn how to handle recovery and recuperation on your own. 

It is projected that you’ll be down after the surgery for up to eight weeks, though that can vary based on different factors. Things like your weight, age, overall health, and more, can determine how long your recovery period is going to be. It is imperative to get as much rest as you can in the months following your surgery as rest and taking it easy will only aid in your healing and let your remaining lung adjust to the workload of both lungs. 

If you’re still struggling with any remaining shortness of breath, feverishness, or other issues after your surgery, you’ll want to consult your doctor immediately.

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