The tumor characteristically remains localized until late in its course, and thus extensive workup at the time of diagnosis is seldom required. Generally, a large piece of tissue obtained via an open biopsy is required for adequate histologic diagnosis. Investigational approaches include taking numerous needle biopsies with samples sent for electron microscopy as well as for immunoperoxidase staining for keratin and CEA.
The mesothelioma treatment of this disease remains unsatisfactory. Occasional patients have remained disease-free for periods in excess of 5 years after intensive treatment, however. The conclusion that mesothelioma is untreatable is clearly untenable since palliation and a response rate of 30 per cent to various chemotherapeutic regimens have been reported by a number of investigators. While many authors have advocated supportive care alone because "current treatments have not demonstrated increased survival," we believe patients with mesothelioma should be offered investigational therapy.(ABSTRACT Several surgical procedures are used to treat mesothelioma. Some mesothelioma surgeries aim to provide a curative effect, while others are performed for palliative purposes (to reduce pain and other symptoms affecting a patient). While treating mesothelioma surgically, a surgeon may remove part of the lining of the chest or abdomen and some of the tissue around it.
In treating pleural mesothelioma, sometimes part of the diaphragm, the muscle below the lungs that helps with breathing, is also removed during surgery because the diaphragm is so connected to the pleura (mesothelial lining of the lungs). Depending on how far the cancer has spread, a lung also may be removed (pneumonectomy).
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