Extrapleural Pneumonectomy (EPP) is a complex surgical treatment that removes the cancerous part of pleura, pericardium, affected lung, diaphragm, and lymph nodes. It was invented by Dr. David Sugarbaker and has been perfected over the last three decades.  It aids patients with Malignant Pleural Mesothelioma to improve their quality of life and extend their estimated survival time. It takes at least 6 weeks to 4 months to fully recover from this convoluted surgery.

Every patient is carefully assessed before being considered for an EPP treatment. They need to be fit enough to endure the convoluted surgery and survive the entire recovery procedure. This also means there would be an increased load on the heart and remaining lung tissue to support the body’s breathing process.

Under the standards laid out by Brigham and Women’s Hospital, patients whose cancer has spread to other organs, surrounding lymph nodes, and tissues are not currently considered candidates for Extrapleural Pneumonectomy. However, in some rare cases, patients with late stage II mesothelioma have also been recommended to EPP treatment.



How Does EPP Help People with Pleural Mesothelioma?

Extrapleural Pneumonectomy is considered as the best and most effective treatment for MPM when diagnosed in the early stages. EPP has been known to improve patients’ breathing problems and extend their life expectancy. According to a study conducted on 529 patients, the median survival time was 18 months. [1] Early prognosis leads to a much better mortality rate. The basic goal of EPP treatment is to eradicate the majority of the tumor and affected tissues; which improves the overall quality of the life. It helps the patients to breath with more ease. It has also been known to improve the patient’s diagnosis when combined with radiation or chemotherapy. This amalgamation of treatments is known as multimodal therapy. In fact, it is seen that patients who underwent an EPP, survived longer than patients who underwent Pleurectomy Decortication or P/D.

Expected Cost of this Treatment

EPP is one of the more expensive treatment options. Depending on several factors like diagnosis, age, health, tumor location, coverage offered by the health insurance company; it may cost you anywhere from thousands to tens of thousands of dollars. Apart from the tests, surgery costs and hospital bills; there are more additional costs like traveling, boarding and other expenses while visiting the EPP or cancer specialist doctors. You must consider all of these related costs as well. Make sure you have a health insurance company and try to negotiate with the hospital administration or the doctor. Also, there are several government programs and legal compensations you may be able to receive aid from.  Those are definitely worth checking out.

There is an argument that EPP is antagonistic and its mortality rate is lower than P/D treatment. There is no eradication of the lung or diaphragm in P/D. However, it is seen the P/D has a lower mortality rate than EPP. Some suggest that the removal of cancerous organs and tissues leaves patients with a better chance of recovery. If you are thinking about an EPP, just opt out for a second opinion from a cancer specialist before making any final decisions. Remember, every patient has their own unique prognosis that will ultimately decide how well they will endure the surgical process and also which treatment option will produce the best opportunity for a healthier quality of life.

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