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Mesothelioma

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Potential side effects of surgery for mesothelioma

Side effects can occur with any type of treatment for mesothelioma, but not everyone has them or experiences them in the same way. Side effects of surgery will depend mainly on the:

  • type of surgery
    • There seems to be less severe risks associated with pleurectomy and decortication (P/D) than with extrapleural pneumonectomy.
  • person’s overall health
  • person’s age

Side effects can happen during, immediately after, or a few days or weeks after surgery. Most side effects go away after surgery. Late side effects can occur months or years after surgery. Some side effects may last a long time or be permanent.

It is important to report side effects to the healthcare team.

Bleeding

Bleeding or hemorrhage can occur if a blood vessel is not sealed off during surgery or if the person has a blood clotting disorder. Nursing staff frequently check bandages and drains for heavy bleeding right after surgery. Bleeding from the chest wall can occur after pleural mesothelioma surgery and from the abdomen after peritoneal mesothelioma surgery. If bleeding occurs and is severe enough, the surgeon may have to take the person back to the operating room to find where bleeding is coming from and to stop it.

A small amount of bloody drainage may be expected after surgery. Report heavy bleeding to your doctor or the healthcare team.

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Pain

Pain often occurs because of trauma to the tissue during surgery. Surgery for pleural or peritoneal mesothelioma is a major operation. It may take time for pain to go away after surgery. The intensity of the pain will depend on the procedure and how the person heals and tolerates pain. Pain-relieving medications are used to control pain. Check with the doctor if pain does not go away or pain medicines do not relieve the pain.

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Nausea and vomiting

Nausea and vomiting can occur because of the effects of general anesthesicanesthesicA drug that causes anesthesia (the loss of some or all feeling or awareness). used during surgery. Medications are often given to prevent and control nausea and vomiting. Nausea and vomiting are usually temporary side effects and often go away a few days after surgery.

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Infection

Some people may develop a wound infection after surgery for mesothelioma. This is not a common side effect, but it can potentially occur after any type of surgery. Sometimes tubes are placed into the wound to drain excess fluid. Antibiotics may be used to help prevent or treat an infection. Wound infections are a temporary side effect of surgery.

Tell your doctor or the healthcare team about signs of infection, such as redness, pus, foul-smelling drainage, fever and increased swelling or tenderness at the incision site.

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Blood clots

A blood clot in the legs is called a deep vein thrombosis (DVT). A DVT can occur immediately after surgery for mesothelioma because the person cannot move around very well, along with other factors. The signs and symptoms of a blood clot in the leg are a swollen, painful and red calf. In the most serious cases, a blood clot can break away and travel to the lungs (called a pulmonary embolus or PE). This can cause shortness of breath, coughing up blood, low oxygen levels in the blood and, potentially, heart failure. A pulmonary embolus can occur after extrapleural pneumonectomy (EPP) surgery for pleural mesothelioma.

Giving anti-coagulants (blood thinners) and applying compression stockings during and after surgery helps to prevent DVT and PE. The healthcare team will also recommend exercises to help prevent blood clots from forming.

Tell your doctor or the healthcare team about any redness, swelling, pain or cramps in the calf of the leg, shortness of breath or coughing up blood.

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Lung problems

Lung problems can occur after surgery for mesothelioma. The main types of lung problems are:

  • respiratory distress
    • Respiratory distress is laboured breathing or shortness of breath. It occurs because of trauma to the lung or when the lung is removed during pleural mesothelioma surgeries. It is treated with oxygen therapy, medications or other measures to support breathing.
  • lung infection
    • Empyema is a collection of pus in the chest cavity. It is more likely to occur after pleurectomy and decortication (P/D) and extrapleural pneumonectomy surgery for pleural mesothelioma. Empyema is an infection, so it is often treated with antibiotics. Chest tubes are also used to help drain the infection.
    • Pneumonia is another lung infection that can occur, especially after pleural mesothelioma surgery. Antibiotics, deep breathing and coughing exercises may be used to help prevent and treat pneumonia.
  • air leak
    • Air can leak from the lung after pleurectomy and decortication surgery for pleural mesothelioma. This can go on for a long period of time. A chest tube or further surgery may be needed to correct an air leak.

The healthcare team will give you breathing exercises to help reduce the risk of these complications developing.

Report laboured breathing, shortness of breath, fever and a dry or productive cough (coughing up mucus or blood) to the doctor or healthcare team.

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Heart problems

Heart problems can occur after extrapleural pneumonectomy (EPP) for pleural mesothelioma. The most common heart problem that occurs after EPP is an abnormal heart beat (atrial fibrillation). People may also have a heart attack (myocardial infarction) after EPP.

The healthcare team will monitor heart function and medications may be used to help prevent these heart problems from occurring.

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Gastrointestinal problems

The intestines may be affected by the anesthetic and may not work as they should. This can cause a problem called paralytic ileus, in which the intestine becomes paralyzed or inactive and stomach contents cannot move through the intestines. This problem is more likely to occur after surgery to the abdomen for peritoneal mesothelioma or a major operation like extrapleural pneumonectomy for pleural mesothelioma. The doctor may insert a tube through the nose and into the stomach (nasogastric tube) until the person can take fluids. Fluids and foods taken by mouth (orally) are started gradually and the person’s bowel activity is checked after surgery.

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