An implantable catheter that allows cancer patients to drain their own excess lung fluid at home may improve quality of life for some mesothelioma patients.
A company-sponsored study of the PleurX drainage system conducted in Germany and published in a German medical journal, suggests that the system may be especially beneficial for late-stage mesothelioma patients. Pleural mesothelioma is a malignancy of the pleural lining which surrounds the lungs. In its later stages, mesothelioma often results in pleural effusions, or a build-up of fluid in the space between the inner and outer parts of the pleura. The problem is also common in the later stages of lung cancer and breast cancer.
Pleural effusions limit the ability of the lungs to expand, resulting in dyspnea (shortness of breath), chest pain, and fatigue. There are several options for dealing with the problem, including a medical procedure to drain off the fluid, which may have to be repeated periodically. Talc pleurodesis, which involves filling the space with a talc slurry in the hope that the two pleural layers will swell and close off the space where fluid had built up, is another option. A third option in a catheter system which is implanted in the hospital, but allows for continuous pleural fluid drainage at home.
In the German test of the PleurX system, mesothelioma and other cancer patients treated with the system between June 2005 and September 2012 were evaluated using a predefined data sheet. Researchers recorded complications associated with the insertion procedure, short- and long-term complications after insertion of the catheter, the rate of pleurodesis (fusing of the pleural layers that can sometimes occur after drainage), frequency of hospitalizations due to effusion-associated symptoms, time of drainage, and survival time after insertion.
For all the patients tested (including mesothelioma), the PleurX system was found to have a low rate of complications – only 7% related to the insertion procedure and 18% for long-term problems, all of which were reportedly managed successfully by their doctors. Sixteen percent of patients experienced pleurodesis and 78% did not need another hospitalization for infusion-related symptoms. The average drainage time was 52 days and most patients lived for an average of 76 days after catheter insertion.
The PleurX system was developed in 1997 and consists of a small catheter, which stays in place under a bandage. To drain pleural fluid, the patient connects the catheter to a drainage line and a drainage bottle. The system is designed to give patients a way to manage their symptoms at home without having to go to the doctor each time their lung fluid builds up. According to the manufacturer, the drainage procedure takes from 5 to 15 minutes for most patients and symptoms usually improve immediately. The system may be available to pleural mesothelioma patients.
Sioris, T et al, “Long-term indwelling pleural catheter (PleurX) for malignant pleural effusion unsuitable for talc pleurodesis”, June 2008, European Journal of Surgical Oncology.
PleurX Catheter System information sheet, CareFusion website.