Treatment choices, side effects and medical care: Pleural effusion and pleurodesis
Pleural effusion and pleurodesis
In some situations a “pleural effusion” develops. This is an abnormal accumulation of fluid, which gathers in the pleural space, the area between the two layers (parietal and visceral pleura), which are round the lung (see Cancerhelp). This may cause a fast heart rate and difficulty with breathing.
When a pleural effusion occurs the doctor may recommend a thoracentesis, the removal of a sample of the fluid to make a diagnosis. A man who was eventually diagnosed with mesothelioma had had this procedure, and a biopsy at the same time; the procedure had not been painful (see also 'Investigations').
Removing the fluid from around the lung can help to relieve breathlessness. The fluid may be drained by drawing it off or by inserting a drainage tube. One man, also diagnosed with mesothelioma, described how fluid was aspirated. He said that the doctor removed one and a half litres of fluid, perhaps too much at once, which made his lung go into 'trauma' and which temporarily made it hard for him to breathe.
The fluid from around the lung often re-accumulates and the doctor may then perform a procedure called a 'chemical pleurodesis' (see Cancerhelp). Local anaesthetic thorascopy is now more widely used to achieve pleurodesis the procedure can be done as an outpatient.
The aim of the pleurodesis is to cause some inflammation between the two layers covering the lung. This inflammation makes the two layers stick together, and a sort of scar obliterates the space between the layers, so preventing further fluid from accumulating.
A variety of agents can be inserted into the pleural space to cause the inflammation, including talc (talc poudrage is now more widely used then talc slurry). One man, who had mesothelioma, was first thought to have had a pulmonary embolism, so he was given warfarin, which made him prone to bleeding. He described his experience of a pleural effusion and the insertion of a chest drain. He then had a pleurodesis operation to prevent blood and other fluid accumulating in the pleural space.
One woman, who had non-small cell lung cancer, had a problem two weeks after her operation. The lung had collapsed so she needed another chest drain, a procedure she found painful. She also had a talc pleurodesis, which was also done on the ward.
Last reviewed May 2010.
Last updated May 2010.
