Pain a Sign of Successful Pleurodesis for Mesothelioma, Study Says

A temporary increase in pain may be a sign of success when undergoing pleurodesis for mesothelioma-related lung fluid.

An uncomfortable build-up of lung fluid is one of the most common and life-limiting mesothelioma symptoms. 

Chemical pleurodesis is one way doctors treat the problem. About three out of four patients have good luck with pleurodesis for mesothelioma. Now, a new study from the UK suggests that those who have the best results with the procedure also tend to have the most pain afterward. 

What is Pleurodesis for Mesothelioma?

Pleural mesothelioma is a malignancy that starts in the layers of the pleura. The pleura is a membrane that surrounds the lungs. 

When tumors grow in the pleural membrane, they can trigger a build-up of fluid between the lungs and the membrane. This fluid is called pleural effusion. Pleural effusion puts pressure on the lungs and makes it hard to breathe. 

Pleurodesis for mesothelioma is a popular way to treat pleural effusion. It involves filling the space between the lungs and the pleura with a chemical irritant like talc. The irritant causes inflammation which closes off the space. 

After successful pleurodesis for mesothelioma, there is no longer any space for fluid to collect.   

What Pain Level Says About Treatment Success

The new study of pleurodesis for mesothelioma and other cancers included 285 UK patients. Patients had an overall pleurodesis success rate of 81 percent. 

Researchers compared the pain levels of people who underwent pleurodesis. They found that those who had the biggest change in their cancer pain during the process had the most success with the procedure.

“There was a significantly higher rise in CRP [cancer-related pain] in the Pleurodesis Success group compared with the Pleurodesis Failure group,” writes Dr. Rachel Mercer. Mercer is with the Oxford Centre for Respiratory Medicine.

Mercer and her colleagues say the pain probably comes from the inflammation happening in the pleural membrane. How much the pain level changed in patients was more closely linked to success than the level of the pain itself. 

Pleurodesis is Not the Only Option

Unfortunately, the team also found that people who had pleurodesis for mesothelioma had a lower rate of success than other types of cancer patients. The researchers say this is probably because there is less healthy pleural tissue to start with. 

A pleural catheter is another option for treating pleural effusion. Doctors implant a catheter to drain off excess fluid as it collects. When it works, pleurodesis for mesothelioma is a longer-lasting solution to the problem. 

An estimated 80 to 95 percent of mesothelioma patients have pleural effusion by the time they receive a diagnosis. 

Source:

Mercer, RM, et al, “Clinically important associations of pleurodesis success in malignant pleural effusion: Analysis of the TIME1 data set”, December 17, 2019, Respirology, Epub ahead of print, https://onlinelibrary.wiley.com/doi/abs/10.1111/resp.13755