A procedure used to treat one of the most common side effects of malignant pleural mesothelioma may be less effective in mesothelioma patients than it is in patients with other types of cancer.
Pleural effusion is a buildup of fluid in the space around the lungs. It is common in patients with mesothelioma and lung cancer, as well as in people with breast cancer and several other tumors.
While most people get some relief from a procedure called talc pleurodesis, new research indicates that those with mesothelioma tumors may have a more subtle response than other patients.
What is Pleural Effusion?
Pleural effusion is a secondary effect of the body’s efforts to defend itself against cancer.
Excess fluid builds up between the layers of the pleura, the lining around the lungs where malignant pleural mesothelioma starts.
As the amount of fluid in the pleural space increases, the ability of the lungs to expand decreases. Many mesothelioma patients then experience shortness of breath which can severely impact quality of life.
Talc Pleurodesis for Mesothelioma-Related Effusion
For patients with mesothelioma-related pleural effusion, doctors often recommend a procedure called talc pleurodesis.
During thoracoscopic talc pleurodesis, the surgeon uses a special scope to see inside the chest cavity. The lung is collapsed and the fluid drained.
Talc is then used to close the space between the pleural layers, preventing future fluid buildup and alleviating shortness of breath, a common mesothelioma symptom.
Effectiveness for Mesothelioma Patients
Unfortunately, new research suggests that talc pleurodesis does not always work as well for mesothelioma patients as it does for others cancer patients.
A new Chinese study analyzed the results of thoracoscopic pleurodesis in 1061 patients with malignant pleural effusion related to pleural mesothelioma or another type of cancer.
Although the overall response rate was better than 88 percent, lung cancer and mesothelioma patients has a more limited response.
“Pleurodesis was less effective in treating effusion caused by lung cancer (72.3%) and mesothelioma (68.2%) than that caused by breast cancer (84.4%) and other tumors (87.8%),” writes lead researcher Dr. Juan Chen in the International Journal of Clinical and Experimental Medicine.
Alternatives to Talc Pleurodesis for Mesothelioma Patients
Despite these results, talc pleurodesis is still one of the most effective ways of treating malignant pleural effusion in mesothelioma patients.
Some alternatives to talc pleurodesis for mesothelioma symptoms include pleurodesis with another type of chemical or drug and pleurocentesis, a procedure in which a long needle is used to draw off excess fluid. Pleurocentesis typically has to be repeated.
Some mesothelioma patients may get a pleural drain which allows them to periodically drain excess fluid at home.
Chen, J et al, “Efficacy of medical thoracoscopic talc pleurodesis in malignant pleural effusion caused by different types of tumors and different pathological classifications of lung cancer”, October 2015, International Journal of Clinical and Experimental Medicine, pp. 18945-53