Pleurodesis for Mesothelioma Treatment

Pleurodesis is a procedure performed on mesothelioma patients to relieve some of the disease’s more debilitating symptoms. Mesothelioma patients often develop malignant pleural effusions, which is the abnormal buildup of fluid in the linings of the lungs, and unfortunately leads to a decrease in quality of life. Effusions cause shortness of breath, coughing, dyspnoea, and chest pain. Pleurodesis aims to prevent effusion accumulation by draining the fluid and then re-attaching the outside of the lung to the inside of the chest cavity, and can be performed either chemically or surgically. Mesothelioma attorneys hope that procedures like pleurodesis will contribute to better life quality for those battling the rare lung cancer.

Surgical pleurodesis is performed manually by a surgeon, who mechanically roughens the pleura, typically with a piece of gauze. This is done so that the lung will be able to more efficiently adhere to the chest cavity, closing off the space so effusions cannot accumulate. The surgery may be performed either through a thoractomy, which is an incision into the chest, or thoracoscopy, which uses a small internal camera and does not require incisions. Surgeries utilizing the thoracoscopic method are usually preferred, as it is less invasive, involves less risk, and often yields more success.

Some surgical pleurodesis procedures are done in conjunction with another type of chemical pleurodesis. During the chemical procedure, an irritant such as talc or doxycycline is instilled into the pleural space, which induces inflammation and ultimately causes adhesion of the lung lining and chest cavity. This can be administered through a chest tube while the patient is awake, or surgically under anesthesia. Talc pleurodesis is the more common method, often recommended to those patients who already have a chest tube in place.

Talc was first used for pleurodesis in 1935, and is approved by the FDA in two forms: as a sterile powder and as an aerosol canister. The talc is administered through a chest tube into the cavity, or, if there is already a chest tube in place, talc can be blown into the cavity using a syringe. The talc acts as an agent causing the lung lining and chest lining to stick together. Suction is then used to remove any remaining air in the pleural space. Side effects of the talc procedure includes a burning sensation in the chest as the area heals, however, this method is usually very effective, and is significantly less expensive than the surgical procedure. As mentioned, other chemical agents, such as doxycycline, can be used in place of talc.

Generally, adverse side effects of any type of pleurodesis include fever, pain, and gastrointestinal symptoms, although serious complications concerning the process are not typically observed. One study by the Department of Clinical Oncology at Velindre Hospital in Wales examined the optimal techniques of pleurodesis for malignant pleural effusions. Comparing different chemical agents, talc was found to be most effective. The probability that effusions would not re-occur was more favorable in those who underwent thoracoscopic pleurodesis compared to only chemical talc pleurodesis. Researchers found that those engaging in both chemical and surgical pleurodesis yielded better success rates.

The study’s evidence supported the need for chemical agents in successful pleurodesis, and the use of talc as the chemical agent of choice. Researchers concluded thoracoscopic pleurodesis as the preferred technique based on overall efficacy. There was no evidence for an increase in mortality following talc pleurodesis.

Another study by Australian researchers, however, did not find that any discernible difference between the two types of procedure. This study found that, in a retrospective review of nearly 400 patients, nearly 32% of pleurodesis required further drainage. No clinical, biochemical, or radiographic parameters tested adequately predicted pleurodesis outcome.

Mesothelioma attorneys at Pintas & Mullins Law Firm highlight the potential benefits of this procedure. Some patients showed a longer medical survival after a successful pleurodesis. One study found that, independent from chemotherapy, the chance of living longer for patients whose pleurodesis was a success was 2.6 times higher. If you or someone you love was diagnosed with mesothelioma or any asbestos-related disease, you may be entitled to compensation, and should contact an asbestos exposure lawyer immediately for a free legal consultation.

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