Implantable Catheter Provides Relief for Mesothelioma Symptoms

Due to the long latency period of the disease, mesothelioma is not often caught until its latest stage. A common symptom of advanced mesothelioma is dangerous fluid build-up in the lungs. Pleural mesothelioma affects the lining surrounding the lungs, and may result in constant effusions between the inner and outer linings. These effusions may also occur in the advanced stages of lung and breast cancer, and result in extreme shortness of breath, chest pain, and chronic fatigue. Patients with pleural effusions sometimes relieve their symptoms with use of an open chest tube, which effectively drains fluid but has a high infection rate. Recent developments have introduced implantable catheters that connect to a drainage line and container.

Mesothelioma attorneys highlight the importance of such systematic developments, which enable patients to have a higher quality of life, fewer visits to the hospital, and decreased risk of infection. A recent study published in theEuropean Respiratory Journal followed the experience of 29 mesothelioma patients implanted with this devise. Their findings provide hope for those suffering from the rare cancer, which is almost exclusively attributed to asbestos exposure. Lung cancer and asbestosis are also directly linked to exposure to the deadly mineral, which was used abundantly in manufacturing until the late 1970s.

The study included 26 males and 3 females with malignant mesothelioma, no previous treatment, and expected survival of more than 3 months. The catheter was implanted via thoracoscopy over a rib to provide support. A trocar was used to make a tunnel, approximately 5 cm long, from the pocket to the site of entry and to puncture the parietal pleura. After insertion of the guide wire, the pleural catheter was threaded under the skin into the pleural cavity.

In 18 of the 29 patients (62%) in this study, no complications occurred. In four patients, placement of the catheter was followed by abnormally large fluid volume in the circulatory system, but this did not interfere with treatment. In seven patients placement was complicated by local suppuration, and one of the patients developed an infection.

The patient responded to antibiotics and the following treatment was completed. For the remaining six patients with complications, the removal of the device was necessary. All but one infected patient first developed localized collection of blood clots immediately after treatment. Infections were not observed in any of the remaining 14 patients. After treatment, the catheter is easily removed.

A variety of methods have been proposed for intracavitary therapy of malignant pleural effusions. Some required repeated installations and have been associated with high infection rates. Despite daily cleansing of the instillation and rinsing of the tube, infection developed in the majority of cases. To reduce or avoid these problems, European Respiratory Journal researches recommend trying the implantable catheter system.

Instillation of the catheter was followed by complete and instant diffusion. In one patient treated with T cell therapy, necrosis of the overlying skin necessitated removal of the device. This complication was attributed to local electrontherapy, which we routinely carry out after thoracoscopy in patients with malignant mesothelioma, to prevent seeding of tumor along the pathway of the trocar. This complication could have been prevented by implanting the catheter outside the irradiated zone and tunneling the catheter to the placement site. Tunneling also minimizes the risk of reflux of the injected product into the pocket.

The infectious complications that were observed in seven patients were probably due to the formation of blood clots around the catheter. This problem was solved by placing a small suction drain in the pocket for a few days.

Using the catheter, local immunotherapy can be an ambulatory procedure. Placement is only a few minutes longer for a catheter than for a chest tube. Patient tolerance is excellent. In the Journal series, most patients did not even feel the device between two treatment sessions. Unlike open chest tubes, which require daily cleaning and rinsing of the tube, catheters require minimal maintenance.

As previously mentioned, mesothelioma is one of numerous disease directly caused by asbestos exposure. If you were exposed to asbestos at any point in time, and developed a related illness, contact an asbestos exposure attorney immediately for a free legal consultation.

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