Reassurance for Mesothelioma Patients with Indwelling Pleural Catheters

Mesothelioma patients with an indwelling pleural catheter (IPC) for pleural effusion can rest assured that the device is unlikely to break down and cause additional problems, even if it is left in place for many months. In fact, IPCs may even eventually facilitate new kinds of mesothelioma treatments.

In the first ever study on how IPCs hold up over time, researchers examined catheters removed from 41 cancer patients, almost half of whom had malignant mesothelioma. The rest had either breast, ovarian or lung cancer.

Although the IPCs had been left in place for a median of 126 days (and some as long as 226 days), they were all fully intact when they were removed and were not hosting new mesothelioma tumors.

IPCs for Pleural Effusion

The buildup of excess lung fluid known as pleural effusion is one of the most life-limiting and bothersome side effects of mesothelioma.

As mesothelioma tumors grow, the body often reacts by filling the pleural space around the lungs with fluid. If not drained off, this fluid puts pressure on the lungs making it difficult and even painful to breathe.

In the past, mesothelioma patients suffering from pleural effusion had to come the hospital repeatedly to have the fluid drawn off with a needle. Surgical procedures to close or even remove the pleural space have also been used.

But in recent years, indwelling pleural catheters, small tubes which stay in place and allow patients to drain their own lung fluid at home, have become more popular.

Mesothelioma Patients and Their IPCs

The first histopathological study of IPCs removed from cancer patients contains good news for mesothelioma patients who are benefitting from these devices.

The study, published in a recent issue of the journal Respirology, included a macroscopic examination of the tubes for evidence of holes or other problems, as well as a microscopic examination of the cells on their surfaces.

Although malignant cells were found in the ends of most of the IPCs, there was no evidence that the devices were harboring tumors.

“Our study provides reassuring evidence that the IPC material does not support direct tumour growth or invasion even in the setting of high mesothelioma prevalence,” writes study author Claire Tobin, MD, of Sir Charles Gairdner Hospital in Western Australia.

New Mesothelioma Treatment Possibilities?

In an editorial in the same issue of Respirology, Jason Akulian, MD, of  the University of North Carolina and Lonny Yarmus, DO, of Johns Hopkins speculate that the reliability of IPCs could make them useful for delivering new kinds of mesothelioma therapies in the future.

“While the next phase of IPC evolution remains opaque, one can imagine a multitude of possibilities that this unassuming device may offer,” write the authors.

They say some of those possibilities could include IPCs coated with a drug that could release over time and/or using the catheters to administer a drug directly into the pleural space to treat mesothelioma.

Sources:

Tobin, C, et al, “HIstopathology of removed indwelling pleural catheters from patients with malignant pleural diseases”, March 19, 2016, Respirology

Akulian, J and Yarmus, L, “If they don’t degrade can indwelling pleural catheters evolve?”, May 24, 2016, Respirology