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There are two primary surgeries for pleural mesothelioma patients: extrapleural pneumonectomy and pleurectomy with decortication.
Some mesothelioma experts suggest a third: talc pleurodesis.
Talc pleurodesis surgery is a low-invasive procedure to relieve a symptom that occurs when too much fluid is in the lung cavity, and it could improve the quality of life and survival time for patients. The operation manages a primary pleural mesothelioma symptom and reduces pain.
Pleural mesothelioma develops in the pleura, which is a thin lining of the chest cavity. When the rare cancer forms, the presence of tumors causes a buildup of excess fluid in the pleura. This fluid buildup is called “pleural effusions” and puts pressure on the chest wall, which can cause chest pain and shortness of breath for the patient.
There are numerous fixes for pleural effusions, such as drainage of the fluid from the pleural space (thoracentesis), but a pleurodesis may be a permanent one. The surgery removes the fluid from the patient’s pleura, which allows the lungs to move normally and the patient to breathe without irritation. Pleurodesis surgery also involves sealing the pleural cavity to prevent future effusions.
To seal the space, doctors inject non-asbestos talc directly into the pleural space. This is called a talc pleurodesis. The talc irritates the pleura causing an inflammatory response which then fuses together the layers of the pleura.
A study published in the Journal of Thoracic Disease showed the long-term benefits of a talc pleurodesis procedure. The research team, which included esteemed mesothelioma specialist Dr. Raja Flores, found that the overall survival rate for patients who underwent this operation was 14 months.
Patients who undergo more-invasive mesothelioma surgeries may survive longer but deal with greater risks and a longer hospital stay. The study reported that patients who underwent extrapleural pneumonectomy (EPP) and pleurectomy with decortication (P/D) had average survival rates of 21 months and 17 months, respectively.
Since pleurodesis surgery is far less invasive than EPP or P/D, there is often a greater chance of success and fewer complications associated with the operation. People can usually return to normal activities quicker after a pleurodesis than more invasive surgeries.
A study published on UpToDate cited a study showing that a pleurodesis with talc has at least a 90% success rate. Success is defined as “fully expanded lung at the end of the procedure and no recurrence of the effusion at long-term follow up,” according to the study.
Therefore, quality of life could be better for patients undergoing a talc pleurodesis procedure.
Most late-stage patients aren’t candidates for either EPP or P/D. Many of them only receive chemotherapy for treatment. However, talc pleurodesis surgery could benefit them.
According to a study in the Journal of Thoracic Disease, patients whose only treatment is chemotherapy survive for an average of 12 months. So talc pleurodesis has a longer average life expectancy. Considering the uncomfortable side effects associated with chemotherapy, undergoing a talc pleurodesis also could be better for quality of life.
Patients may have questions about their options. While palliative treatments like a pleurodesis procedure are beneficial, patients need to seek the best possible medical care when undergoing any operation. Our patient advocate team connects patients to mesothelioma specialists who can effectively perform the surgery best suited for their disease.
If you’re a newly diagnosed patient — with either an early stage cancer or late-stage disease — contact registered nurse Karen Ritter by email at karen@mesotheliomaguide.com. She’ll help you find a specialist to treat your cancer, prolong your life and increase your quality of life.
Pleurodesis is a procedure for malignant pleural mesothelioma cancer to remove fluid buildup and seal shut the pleural lining. Pleural mesothelioma forms in the pleura, which is a thin lining between the lung cavity and chest wall. When tumors form and grow, it causes a buildup of fluid, which is called pleural effusions. Pleurodesis treats pleural effusions and prevents future effusions since the pleural is sealed shut.
Talc pleurodesis is a type of pleurodesis where doctors use talc to seal shut the pleura. Pleurodesis is a minimally invasive surgery to seal shut the pleura and prevent the buildup of fluid in the pleura, a thin lining around the lungs. This buildup is called pleural effusions and it’s a main symptom of pleural mesothelioma cancer. Talc is used to irritate the pleural tissue linings and cause them to stick together and seal shut.
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