Pleural mesothelioma patients considering pleurodesis for excess lung fluid should know that there is very little data on how this procedure may affect survival or even quality of life.
That is the conclusion of researchers at Mount Sinai Medical School in New York. Scientists with the Institute for Translational Epidemiology combed the medical literature for studies demonstrating mesothelioma survival after talc pleurodesis for lung fluid buildup. They did not find much useful information.
Given how often the procedure is used to treat lung fluid accumulation in mesothelioma patients, they say more study is needed to help patients and doctors to make more informed decisions.
Talc Pleurodesis in Pleural Mesothelioma
Talc pleurodesis is one of the methods used to alleviate pleural effusion in patients with malignant mesothelioma and other types of cancer. Pleural effusion is a buildup of excess lung fluid in the space between the layers of the membrane (pleura) surrounding the lungs.
Pleural effusion is common in patients who have been diagnosed with mesothelioma and can contribute to one of the most common symptoms of the asbestos cancer – shortness of breath.
As fluid accumulates, the pleura becomes less flexible, restricting the normal expansion of the lungs and making it harder to get a deep breath.
During pleurodesis, the space between the pleural membranes is filled with a talc mixture. The talc and the body’s reaction to it effectively fills in the gap, reducing the chance that fluid will accumulate there in the future.
Mesothelioma Survival After Talc Pleurodesis
Talc pleurodesis can help manage mesothelioma symptoms. But the new report from Mount Sinai, which included data from 49 other articles, says not enough is known about how the procedure compares with surgery in terms of survival or even quality of life.
What is known is that the mean survival among mesothelioma patients who had pleurodesis was 14 months, compared to 17 months for mesothelioma patients who had pleurectomy with decortication (P/D) surgery and 24 months for those who underwent radical EPP surgery.
Few of the studies included any data on overall one- or two-year survival among mesothelioma patients who underwent pleurodesis. The researchers say there was also not enough data on how the procedure impacted quality of life for those with a mesothelioma diagnosis.
“This review shows that there is limited research on the survival rate after talc pleurodesis compared to surgery in the treatment of malignant pleural mesothelioma,” writes lead author Emanuela Tailoi in the Journal of Thoracic Disease. “A comparison study is necessary to accurately assess the best way to treat malignant pleural mesothelioma patients, including assessment of the quality of life after treatment as an outcome measure.”
Regardless of the findings of any future studies on talc pleurodesis, the choice of how best to alleviate the symptoms of pleural mesothelioma, including pleural effusions, is always highly individualized. Studies consistently show that patients treated in larger cancer centers with experienced mesothelioma doctors have the best outcomes.
Taioli, E, “Review of malignant pleural mesothelioma survival after talc pleurodesis or surgery”, December 2017, Journal of Thoracic Disease, pp. 5423-5433