From the blog

Pain Shows the Success or Failure of a Pleurodesis

Published: January 17, 2020

Mesothelioma is a painful cancer that is caused by asbestos exposure. Patients who are diagnosed must live with multiple uncomfortable symptoms, but thankfully there are some treatments available to help improve a patient’s quality of life. One of these procedures is a pleurodesis, which helps to drain fluid surrounding the lungs.

A common and uncomfortable symptom of mesothelioma is a pleural effusion, where fluid builds up around the lungs. This can be very uncomfortable for patients and can make it hard to breathe for those already suffering. There is relief from this experience though, which is a pleurodesis. When someone undergoes a pleurodesis, the fluid is drained and the layers of the pleural lining are irritated. This causes inflammation and scarring, which then fuses the two layers of the pleural lining together.

There are two main types of pleurodesis, with chemical pleurodesis being the most common type. It uses talc, which allows it to be very cost effective. Talc is usually added to the pleura, which is the lining of the lungs. Other types of materials that can be used include bleomycin, tetracycline, nitrogen mustard, and povidone iodine. The problem with these materials is that they are far more expensive than talc to treat cancer patients, who are already undergoing other costly treatments. Another pleurodesis method is irritating the lining mechanically using a rough pad, brush, or gauze. After doing either type, the space where the fluid built up is closed and prevents fluid from being built up again.

In a study of 285 patients, researchers found that the patients with the most success had the biggest change in pain. For the group of people whose pleurodesis was successful, they saw more cancer related pain than the non-successful group. Patients who had a pleurodesis done were also less successful than other cancer patients because of the lack of healthy pleural tissue. Another treatment that can be done for a pleural effusion uses a pleural catheter which is inserted to help drain fluid, but this does not last as long as other treatments.

Rachel M Mercer et al. “Clinically important associations of pleurodesis success in malignant pleural effusion: Analysis of the TIME1 data set” Respirology (December 17, 2019). [Link]
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