Mesothelioma is a type of cancer that occurs in people who were continuously exposed to asbestos. It is rare but also aggressive and develops in the mesothelial cells that constitute the lining of some organs. Asbestos was used in industries like construction, shipbuilding and manufacturing, but it is now known to be toxic. Asbestos fibers can be released into the air and inhaled or swallowed by people. The human body cannot properly expel them and the fibers stay trapped in the mesothelium, causing the formation of tumors.
When mesothelioma develops in the lungs, it is known as pleural mesothelioma and it accounts for about 70% of all cases. However, there are three other forms, which are peritoneal, pericardial and testicular mesothelioma. There is currently no cure for mesothelioma, but there are treatments meant to increase survival and ease the symptoms, which include chest pain, shortness of breath, reduced chest expansion, faint or harsh breathing sounds, dry cough or wheezing, pleural effusions, coughing up blood, body aches and blood clotting disorders, in the case of pleural mesothelioma.
Pleurodesis Surgical Procedure
Pleurodesis is among the surgical options for the treatment of patients with pleural effusions, which is a common symptom of mesothelioma. Pleural effusions consist on a buildup of fluid in the pleural space of the lungs and it causes numerous other problems, such as shortness of breath and chest pain. During a pleurodesis, physicians drain the fluid and stick the two layers of the pleura together to prevent the fluid from accumulating again.
The surgery starts with the draining of the fluid, keeping the pleural space free of fluid. After that, there are two options that can be used with the same purpose of producing inflammation on the pleural lining. Chemical pleurodesis consist on the insertion of asbestos-free talc through the chest tube in order for the pleural space to seal with scar tissue, while mechanical pleurodesis consist on irritating the pleura with a rough pad, gauze or a mechanical rotary brush and it involves a more invasive surgery. “Before the procedure, patients will usually be medicated with a narcotic for pain and a benzodiazepine (such as Xanax) for comfort. Because of cheap cost and ease of the procedure, a chemical pleurodesis with talc is the most common pleurodesis method,” adds the center.
Benefits and Risks of Pleurodesis
One of the advantages of a pleurodesis is the short recovery, while patients often experience improvements in their breathing capacities after the procedure. Shortness of breath, cough, fever and pain are common symptoms that are reduced due to pleurodesis. While there is not much research on the procedure, trials conducted with patients who suffered from malignant pleural effusions related to mesothelioma revealed a success rare between 90 and 93%. However, like in any other surgical procedure, there are risks and the possibility of side effects.
The most common adverse effects of a pleurodesis are chest pain and fever, while there are also reports of a tight or burning feeling around the lungs. These side effects are often temporary and eased with resource to medication. Given the characteristics of a pleurodesis, which causes an intentional inflammatory response in the pleura, fever normally occurs four to 12 hours following the procedure, and there is also the possibility of infection. There is also a very low risk of developing mesothelioma tumors in the insertion site of the chest tube, a problem known as seeding, but it can be addressed with radiation therapy following the pleurodesis. Cardiovascular complications and Adult Respiratory Distress Syndrome (ARDS) may also occur, but are particularly rare as well.