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 is a low-invasive procedure and could improve the quality of life and survival time for late-stage pleural mesothelioma patients. The operation manages a primary pleural mesothelioma symptom and reduces pain.
Pleural mesothelioma develops in the pleura, which is a thin membrane separating the chest wall and lung cavity. When the rare cancer forms, the presence of tumors causes fluid to build up 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, but a pleurodesis is a potential permanent one. The operation removes the fluid from the patient’s pleura, which allows the lungs to move normally and the patient to breathe without irritation. The 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. 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 talc pleurodesis. The research team, which included esteemed pleural 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 pleural mesothelioma surgeries may survive longer but deal with greater risks. 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 talc pleurodesis is far less invasive than EPP or P/D, there is often a greater chance of success and fewer complications associated with the operation. A study published on UpToDate cited a study showing that talc pleurodesis 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 talc pleurodesis.
Most late-stage pleural mesothelioma patients aren’t candidates for either EPP or P/D. Many of them only receive chemotherapy for treatment. However, talc pleurodesis 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.
While palliative treatments like talc pleurodesis 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 pleural mesothelioma patient — with either an early stage cancer or late-stage disease — contact registered nurse Jenna Campagna by email at firstname.lastname@example.org. She’ll help you find a specialist to treat your cancer, prolong your life and increase your quality of life.
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