Treating pleural effusion
On this page, we cover how pleural effusion (build-up of fluid) is treated.
It’s common in mesothelioma to get a build-up of fluid in your chest called pleural effusion. It can make people feel breathless, so doctors aim to remove the fluid and prevent it from coming back. There are different ways of treating pleural effusions, which are all as good as each other in terms of improving breathlessness. Each treatment has its own benefits and downsides and different methods will suit different people. Your doctor will discuss the options with you and together you can decide which treatment works best for you. The different treatments are described below, but you can read more about pleural effusion treatments and start thinking about which one might suit you on the My Pleural Effusion Journey website.
Doctors can remove the fluid from your chest using a thin needle. They can repeat this procedure as many times as necessary. However, because the fluid almost always comes back, it’s not ideal for you to have to keep having this done. Additionally, in some people the taps become less and less helpful the more they have. Generally, doctors will only choose for you to have repeated pleural taps if:
- you have a very small effusion, or
- you have an effusion that does not make you particularly breathless, or
- your effusion takes a very long time to build up between taps.
Your doctors might try to stop the fluid building up with a procedure called pleurodesis. This involves draining off the fluid that’s there and then injecting sterile talcum powder into the pleural space between the two layers of your chest lining. This causes the two layers to stick together so there’s nowhere for fluid to build up again.
A pleurodesis can be performed in different ways. Sometimes a thin plastic tube called a chest drain is inserted into the pleural space around your lungs to allow the fluid to drain away. Before the drain is inserted, your skin is numbed with local anaesthetic. Once the fluid has been removed, talcum powder is put down the drain into the pleural space. A day or two later the drain is removed.
The other way to perform a pleurodesis is to put talcum powder in during a thoracoscopy procedure.
This is when a thin tube (called a catheter) is inserted into your chest and tunnelled under the skin in your armpit. It’s left in place so fluid can be drained off as and when needed. The catheter is put in as a day case procedure, under local anaesthetic. Once it is in, you can go home with the catheter hidden under a dressing. The catheter then gets drained at home, either by district nurses or by a member of your family if they wish to be trained how to do it. This avoids the need for you to come into hospital for repeated drainages or for pleurodesis. In some hospitals, doctors can squirt talcum powder down the catheter as an outpatient pleurodesis procedure that avoids you needing to come into hospital.
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