Most pleural mesothelioma patients experience pleural effusion, the buildup of fluid in the pleural space around the lungs. This fluid can cause pain for patients by restricting the lungs from expanding normally. Luckily, doctors have several minimally invasive options for removing this fluid to help mesothelioma patients breathe easier.
Step 1: Diagnose the Issue
The first step of treating a pleural effusion is to positively identify it. Doctors usually use an X-ray to get an image of the effusion, but sometimes they will use a computed tomography (CT) scan. Doctors use imaging to check for pleural effusion if their patient is showing certain symptoms.
The symptoms of pleural effusion include:
- Chest pain
- Pleurisy (inflammation of the pleura)
- Dyspnea (shortness of breath)
- Dry cough
Pleural effusion is one of the early signs of pleural mesothelioma. As the disease progresses, pleural effusions are less common in patients. This can be because doctors have treated the effusion effectively or because the tumor has grown and taken over the pleural space.
Let your doctor know if you have any of the symptoms of pleural effusion so that they can help reduce your discomfort.
Step 2: Drain the Fluid
Controlling pleural effusion is an important part of palliative care and symptom management for mesothelioma. Draining the fluid around the lungs can help patients breathe easier and reduce pain. Doctors usually drain the fluid in the pleural space through a process called thoracentesis.
Thoracentesis is a short and simple procedure to drain the fluid from the pleural space using a needle. This procedure usually only takes about 15 minutes and is done while the patient is awake.
Steps of Thoracentesis:
- 1The patient is positioned on the edge of a chair or bed with their head and arms resting on a table. Sometimes the patient is lying down.
- 2Doctors often perform an ultrasound to find the best place to drain from.
- 3The area is cleaned and then numbed so the patient isn’t uncomfortable.
- 4A needle or tube is inserted into the pleural space. The patient may feel uncomfortable pressure but needs to stay as still as possible.
- 5The fluid is drained into a bag or other container.
- 6Some patients are asked to stay overnight to be monitored.
Step 3: Find a More Permanent Solution
Some patients experience pleural effusions multiple times. These patients need a more permanent solution if their fluid has already been drained once and returned. Preventing the reaccumulation of fluid is an important step to improving long-term quality of life for pleural mesothelioma patients.
Doctors choose treatment options depending on the patient’s unique health needs. Below are two common options:
- Pleurodesis – Pleurodesis is a procedure that seals the pleural space to prevent fluid buildups. Doctors usually do this by injecting talc between the layers of pleural around the lungs. The talc irritates the pleura and causes them to fuse together.
- Indwelling Catheter – An alternative to pleurodesis is inserting an indwelling pleural catheter. The catheter is a small tube that can drain fluid from the lungs. Once the catheter is in place, the fluid can be drained regularly at home with instructions from the doctor.
- Assessment of patient-reported outcome measures in pleural interventions. National Center for Biotechnology Information. Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/28883922. Accessed: 9/18/17.
- Malignant pleural mesothelioma: an update on investigation, diagnosis and treatment. European Respiratory Review. Retrieved from: http://err.ersjournals.com/content/25/142/472. Accessed: 9/18/17.
- What Is a Pleural Effusion?. WebMD. Retrieved from: http://www.webmd.com/lung/pleural-effusion-symptoms-causes-treatments#1. Accessed: 9/18/17.
- Thoracentesis. Healthline. Retrieved from: http://www.healthline.com/health/thoracentesis#overview1. Accessed: 9/18/17.
- Indwelling pleural catheter. Cancer Treatment Centers of America. Retrieved from: http://www.cancercenter.com/treatments/indwelling-pleural-catheter/. Accessed: 9/18/17.
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