I am due to have pleurodesis treatment. I would like to know what this is and how it is done?
It is quite common for fluid to collect when cancer affects the lungs, causing breathlessness. Fluid can gather between the sheets of tissue covering of the outside of the lung and lining the chest cavity. These sheets of tissue are called the pleura.
You can see the pleura in the diagram below:
Doctors call this fluid collection a pleural effusion, as in the diagram below:
The fluid stops the lung from fully expanding when you breathe. So as it builds up, the collected fluid will cause shortness of breath.
You can have treatment to stop this fluid from building up and help relieve the symptoms. This treatment is called pleurodesis. It seals the space between pleura with sterile talc. The idea is to put in something that will irritate the pleura. This makes them stick together. Then there is no space in which the fluid can collect. This can be done as an outpatient treatment. But this may depend on how well you are. You may have to stay in hospital overnight if there is a lot of fluid to drain off as this can take some time and the nurses will want to keep an eye on you.
This treatment does not treat the cancer. But it is very useful for relieving difficult symptoms such as breathlessness. It should be easier to breathe after this treatment. If it doesn't work completely the first time, then you can have it done again.
If you have had fluid drained from your pleural effusion before, you will know what to expect, as the procedure is very similar. First, your doctor will have to give you a small injection of local anaesthetic. When this has worked, the doctor will put a wide needle (cannula) into your chest, usually through your side. The tip of the needle goes into the space where the fluid is collecting. This is attached to a drainage tube called a chest drain and a collecting bottle or bag. Your doctor will put a stitch (called a purse string suture) around the tube to hold it in place.
If there is fluid on your chest, your doctor will want to drain it off first. As long as the drainage bottle or bag is kept lower than your chest, this will happen automatically. If there is a lot of fluid, draining it can take a while. It has to be slow, because draining off a large amount of fluid too quickly can make your blood pressure drop suddenly and you may feel faint.
Once the fluid has stopped draining, the doctor injects the talc into the pleural space through the drain. The drain is clamped and left for an hour. During that time, you will be asked to lie in different positions on your bed – on one side and then the other, for example. This is to help the drug or talc circulate between the pleura. After that, your doctor may want the drain to be attached to some suction. This helps the pleura to stick together. As the aim of putting in the talc is to irritate and inflame the pleura, it is not surprising that this part of the process can be a bit uncomfortable. For most people this is mild and doesn't last long. But do tell your doctor if it is a problem for you.
After all this, your doctor or nurse will take the drain out and pull the stitch tight to close the small opening in your chest wall. The stitch stays in for about a week.
Article Resources: http://www.cancerhelp.org.uk/help/default.asp?page=5291
You can see the pleura in the diagram below:
Doctors call this fluid collection a pleural effusion, as in the diagram below:
The fluid stops the lung from fully expanding when you breathe. So as it builds up, the collected fluid will cause shortness of breath.
You can have treatment to stop this fluid from building up and help relieve the symptoms. This treatment is called pleurodesis. It seals the space between pleura with sterile talc. The idea is to put in something that will irritate the pleura. This makes them stick together. Then there is no space in which the fluid can collect. This can be done as an outpatient treatment. But this may depend on how well you are. You may have to stay in hospital overnight if there is a lot of fluid to drain off as this can take some time and the nurses will want to keep an eye on you.
This treatment does not treat the cancer. But it is very useful for relieving difficult symptoms such as breathlessness. It should be easier to breathe after this treatment. If it doesn't work completely the first time, then you can have it done again.
If you have had fluid drained from your pleural effusion before, you will know what to expect, as the procedure is very similar. First, your doctor will have to give you a small injection of local anaesthetic. When this has worked, the doctor will put a wide needle (cannula) into your chest, usually through your side. The tip of the needle goes into the space where the fluid is collecting. This is attached to a drainage tube called a chest drain and a collecting bottle or bag. Your doctor will put a stitch (called a purse string suture) around the tube to hold it in place.
If there is fluid on your chest, your doctor will want to drain it off first. As long as the drainage bottle or bag is kept lower than your chest, this will happen automatically. If there is a lot of fluid, draining it can take a while. It has to be slow, because draining off a large amount of fluid too quickly can make your blood pressure drop suddenly and you may feel faint.
Once the fluid has stopped draining, the doctor injects the talc into the pleural space through the drain. The drain is clamped and left for an hour. During that time, you will be asked to lie in different positions on your bed – on one side and then the other, for example. This is to help the drug or talc circulate between the pleura. After that, your doctor may want the drain to be attached to some suction. This helps the pleura to stick together. As the aim of putting in the talc is to irritate and inflame the pleura, it is not surprising that this part of the process can be a bit uncomfortable. For most people this is mild and doesn't last long. But do tell your doctor if it is a problem for you.
After all this, your doctor or nurse will take the drain out and pull the stitch tight to close the small opening in your chest wall. The stitch stays in for about a week.
Article Resources: http://www.cancerhelp.org.uk/help/default.asp?page=5291
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