Doctors will perform various types of surgeries and procedures depending upon the primary goal of your mesothelioma treatment. One example is palliative surgery. Palliative surgery is aimed at relieving the symptoms of mesothelioma and providing relief for the patient.

Paracentesis is a palliative surgery performed on patients of peritoneal mesothelioma, which affects the stomach and abdomen. During this procedure, a long, thin needle is inserted into the belly to drain accumulated fluid. This fluid, known as ascites, can negatively impact the stomach, kidneys and intestines. Draining the ascites provides the mesothelioma patient with relief from the pain and pressure of having extra fluid.

In order to prepare for paracentesis, you need to tell your mesothelioma doctor:

• If you are taking any medication
• If you have any allergic reactions to medicines, including numbing medicines
• If you have any bleeding problems, or are taking blood thinners or aspirin
• If you are pregnant

Your doctor will numb the area before inserting the needle, and then drain the fluid. Depending upon the amount of fluid to be drained, the procedure can take anywhere from a few minutes to days. Paracentesis can be performed in the doctor’s office, the hospital or an emergency room.

Remember to follow your post-operative care instructions carefully, and let your doctor know of any issues you have after the procedure. Also, make sure to document all the information you receive during and after the procedure for future reference.

Often your doctor will recommend chemotherapy as part of your mesothelioma treatment. There are various types or classes of chemotherapy drugs available. These drugs are frequently used in combination to form an overall treatment, as in the case of Alimta and Cisplatin. One class of chemotherapy drugs is derived from multiple types of plants, called plant alkaloids.

Plant alkaloids are cell-cycle specific, meaning they attack the cancer cells during various phases of division. The various plant alkaloid types include:

• Vinca alkaloids made from the periwinkle plant (catharanthus rosea)
• Taxanes made from Pacific Yew tree bark (taxus)
• Podophyllotoxins made from the May apple plant.
• Camptothecan analogs made from the Asian “Happy Tree” (Camptotheca acuminate

Vinca alkaloids and taxanes are also known as antimicrotubule agents, meaning they prevent cell division and replication, eventually resulting in cell death. Podophyllotoxins and camptothecan analogs are also known as topoisomerase inhibitors, meaning they interrupt the DNA of the cell, which also eventually results in cell death.

The popular chemotherapy drug names for each of these plant alkaloids include:

• Vinca alkaloids – Vincristine, Vinblastine and Vinorelbine (Navelbine)
• Taxanes – Paclitaxel and Docetaxel
• Podophyllotoxins – Etoposide and Tenisopide
• Camptothecan analogs – Irinotecan and Topotecan

Chemotherapy drugs often have side effects, such as nausea, vomiting, fatigue, weight loss and hair loss. It is very important to discuss details about your mesothelioma treatment with your doctor, particularly with regard to any medications you are taking, or any health issues you may have.

We understand you have a lot of questions that require answers in a short period of time. Research takes time, and sometimes it would be nice to speak with someone who can help you sort out the details. Contact one of our mesothelioma family advocates to ask questions and learn about your options. They can help.