Treating Mesothelioma-Related Lung Fluid Build-Up

A buildup of excess fluid around the lungs – also known as pleural effusion – is one of the most common and life-limiting side effects of malignant pleural mesothelioma.

As fluid fills up in the pleural cavity, the mesothelioma patient’s lungs have less room to expand leading to chest pain, fatigue, and shortness of breath.

While there are many different ways of approaching the problem of pleural effusion in the treatment of mesothelioma, a new study says the benefits of a drainage catheter that stays in place probably outweigh the risks – especially as doctors become more familiar with the best way to use it.

Pleural Effusions in Mesothelioma

Pleural effusions are a common side effect of pleural mesothelioma and a number of other cancers and conditions.

As pleural mesothelioma progresses, fluid can accumulate between the layers of the membrane (pleura) that surrounds the lungs.

While the pleural membrane is normally pliable and able to move smoothly with the movement of the lungs, pleural effusions can keep it from expanding normally, limiting lung movement.

Pleural effusions in mesothelioma patients are usually diagnosed with an imaging test such as an X-ray, CT scan, or Ultrasound.

Lung Fluid Drainage with an Indwelling Pleural Catheter

An indwelling pleural catheter (IPC) is a small tube used to drain the excess fluid from the space around the lungs of people with mesothelioma or another kind of cancer.

A tube about as thick around as a pencil is inserted into the chest wall and stays in place so that fluid can periodically be drained from the outside. In most cases, the tube does not limit a mesothelioma patient’s activities.

IPCs are often preferred over other drainage techniques because there is less risk and pain than repeatedly inserting a needle to draw off fluid.

IPC for Mesothelioma Side Effect: Risks and Solutions

Although IPCs are not without risks, a new evaluation conducted by scientists at the University of Western Australia suggests that most of them can be dealt with fairly easily. Below are some potential complications and their solutions:

Potential Complication: Pleural infection (less than 5% of patients) Solution: Antibiotic therapy (Removal of the catheter is rarely needed)

Potential Complication: Metastasis of mesothelioma tumors around the catheter tract Solution: External beam radiotherapy

Potential Complication: Mild chest pain following insertion Solution: Pain relieving medication

Other potential complications including catheter blockage by fibrin clots can also occur. But the research team says, as doctors get more used to using IPCs for pleural effusions in mesothelioma patients, it will become easier to address complications.

Source:

Lui, MM, et al, “Complications of indwelling pleural catheter use and their management”, February 5, 2016, BMJ Open Respiratory Research