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	=== Multimodality Therapy ===		=== Multimodality Therapy ===

-	All of the standard approaches to treating solid tumors–radiation, chemotherapy, and surgery–have been investigated in patients with malignant pleural mesothelioma. Although surgery, by itself, is ineffective, surgery combined with adjuvant chemotherapy and radiation (trimodality therapy) has produced significant survival extension (3-14 years) in a subset of patients with favorable prognostic factors (Sugarbaker, 1999). Reducing the bulk of the tumor with cytoreductive surgery is key to extending survival. Two surgeries have been developed: extrapleural pneumonectomy and pleurectomy/decortication. There is a common misperception that these operations are interchangeable. In fact, the selection of operation for a particular patient depends on the size of the patient’s tumor. This is an important consideration, because tumor volume has been linked with survival (Pass, 1998). Pleurectomy/decortication, which spares the underlying lung, may improve survival, but should only be performed in patients with early stage disease with the intention of removing all gross visible tumor (macroscopic complete resection), not simply for palliation (Sugarbaker, 2006). For more bulky, advanced stage tumors, however, sparing the lung at the expense of cytoreduction is not recommended, provided that the patient can tolerate pneumonectomy. In this circumstance, an extrapleural pneumonectomy should be performed (Sugarbaker, 2004). This is a more extensive operation that involves resection of the parietal and visceral pleurae, underlying lung, ipsilateral diaphragm, and ipsilateral pericardium.	+	All of the standard approaches to treating solid tumors–radiation, chemotherapy, and surgery–have been investigated in patients with malignant pleural mesothelioma. Although surgery, by itself, is ineffective, surgery combined with adjuvant chemotherapy and radiation (trimodality therapy) has produced significant survival extension (3-14 years) among patients with favorable prognostic factors (Sugarbaker, 1999).

	==Notable people who died from mesothelioma==		==Notable people who died from mesothelioma==

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