Pleurodesis Treatment

After someone is diagnosed with Mesothelioma or malignant pleural effusion, they have several treatment options available. If the fluid accumulation in the lungs is causing the patient to have trouble breathing, a thoracic surgeon may recommend pleurodesis which is also sometimes called chemical pleurodesis.

Pleurodesis uses a chemical agent (a sclerosing agent) to cause an irritation between the two layers that cover the lung (the parietal and visceral pleura). The chemical causes the tissues to become inflamed, closing or obliterating the tiny space between the layers where the fluid accumulated. This also prevents any more fluid from collecting in these spaces. The chemical used in this procedure may be one of several including talc, bleomycin, and doxycycline.

Pleurodesis is administered in Two Ways

Either in the hospital bed or in the operating room. The doctor will usually decide which best suits the patient.

Bedside

1) In the bedside method, a chest tube is inserted to drain fluid after a local anesthetic is injected. Most patients will also be given a sedative. The tube is usually inserted near the underarm in lower chest area. The chest tube will be taped in place with a dressing. The fluid causing the breathing difficulty will be drained through the chest tube using suction to aid in the drainage. It can take several days for the fluid to drain out all the fluid. The collection container used in pleurodesis is called a Pleur-e-vac.

After the fluid is drained, the chemical agent, often talc is injected through the chest tube into the pleural space. The tube is clamped, to prevent the agent from draining back out. The patient will be asked to move around and change position in help spread the chemical in the chest. Additionally the chest tube is still attached to a Pleur-e-vac suction device, which is used to bring the two lung surfaces together. This usually takes several hours.

Overall the chest tube is in place for a several days, during the drainage process. This is an unpleasant procedure, as the chest tube is uncomfortable and the patient may need pain killers.

Operating Room

2) The second procedure uses thoracoscopy (also called video-assisted thoracoscopy (VATS) surgery). The patient is given a general anesthetic, by an anesthesiologist. The thoracic surgeon makes a small incision in the chest and inserts a thoracoscope. The surgeon can see the inside of the patients lung and inserts the agent directly on the pleural surface, after draining the fluid. This procedure has a greater risk of complications including the danger inherent in all general anesthetic, the risk of internal bleeding and infection. Many surgeons feel this procedure believe allows the agent to be more efficiently inserted. However, there are no conclusive evidence to support this.


Unfortunately, not every patient with serious pleural effusion can be treated with pleurodesis.

Additionally, although the procedure is proven to provide some relief, it does not work in every case. Patients with a short life expectancy of several months may not be candidates. Patients with a very low lung capacity or function or patients with a trapped lung also are not considered good candidates. A lung is "trapped" when it can no longer expand in the chest after the fluid is drained. A trapped lung occurs when the lungs are damaged by tumors or scarring. Since the lung cannot not Re expand, pleurodesis will not work.

Under the current programs, pleurodesis may be available to patients who qualify. Additionally, patients with mesothelioma may be entitled to large settlements to pay for treatment against employers or asbestos makers.

If you would like more information about Mesothelioma or your legal rights