What is Thoracentesis Treatment for Mesothelioma?

By - on June 4, 2020

Last Updated: June 4th, 2020

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Many people who have pleural mesothelioma have fluid buildup around the lungs that can lead to many unpleasant symptoms and health problems. While mesothelioma cannot be cured, there are treatments and procedures that can extend your life and reduce pain and discomfort. (Mesothelioma.com)

One of the most common procedures for mesothelioma patients is a thoracentesis, also referred to as a pleurocentesis. This is a minimally invasive medical procedure that removes some or all of the fluid buildup in the lungs. It can reduce shortness and breath and chest pain in many patients. Some patients can have a thoracentesis several times during their treatments to alleviate some of their symptoms. (NIH.gov)

How Thoracentesis Treats Mesothelioma

Thoracentesis can be a diagnostic or palliative treatment option for people with pleural mesothelioma. For these patients, a thoracentesis can reduce shortness of breath, chest pain, and cough, which often occur from a pleural effusion. While a small amount of pleural fluid in the chest cavity lubricates the lungs as they expand, too much fluid can cause pain and discomfort.

To prepare you for a thoracentesis, your doctor will usually do an imaging test to check how much fluid is around your lungs. This could be a chest X-ray, ultrasound, or CT scan. Once the amount and location of the fluid are determined for removal, your doctor will initiate the procedure.

Thoracentesis Procedure For Mesothelioma

Below are the typical steps for a thoracentesis:

  1. When a patient is having this procedure, he is seated upright in a hospital bed or examination table and asked to lean forward on an over-the-bed table. The positioning helps to make more space between the ribs so the doctor can access the pleural fluid.
  2. Once the patient has been positioned, the physician inserts a hollow needle between the ribs into the pleural cavity. The fluid is then removed with the needle or with a hollow tube (if there is excessive pleural fluid present). When the procedure is done, there is usually little pain, Numbing agents are used during the thoracentesis, so the patient usually only feels a slight pressure where the needle is inserted.
  3. This procedure may be done in the hospital or on an outpatient basis. If the patient stays overnight, he or she is usually released the next day.

Thoracentesis may be used during the diagnosis process for mesothelioma. When used in this manner, it is considered a form of fluid biopsy. A biopsy is the only certain way to diagnose mesothelioma. The procedure also can be used to diagnose congestive heart failure, bacterial infections, and other cancers. (WebMD.com)

Diagnostic application of thoracentesis is approximately the same as the palliative treatment, but the fluid that is removed will be transported to a laboratory for analysis to confirm cancer.

Who Is Eligible for Thoracentesis?

A thoracentesis is a non-invasive procedure that is appropriate for most pleural mesothelioma patients, especially those with pleural effusions. (Thoracic.org). But patients with blood disorders or who are on anticoagulants may not be suitable candidates; they are at higher risk for various bleeding side effects.

In those cases, a CT scan or chest X-ray may be used to determine if thoracentesis is necessary.

For patients who are eligible for the treatment, benefits are:

  • The lungs will be able to expand fully, improving the ability to breathe
  • Reduced pain and breathing trouble
  • Less chest tightness and pain

Risks and Side Effects of Thoracentesis Treatment for Mesothelioma

Thoracentesis is a non-invasive procedure, so recovery time is minimal. After the thoracentesis is complete, your physician will put a bandage on the insertion site. It should heal on its own with no stitches needed. You may be given a chest X-ray after the procedure to ensure no damage was caused during the procedure, such as a puncture in the chest wall.

If the procedure was done on an outpatient basis, you will need to be taken home afterward. You should be able to go back to regular activities once you are home. But it is wise to avoid strenuous activity for a week or so after the procedure.

A thoracentesis is generally safe, but there are possible side effects. For most mesothelioma patients, the benefits far outweigh the risks. Some side effects of thoracentesis are:

  • Air in the pleural space
  • Bleeding
  • Pneumothorax (collapsed lung)
  • Coughing
  • Fainting
  • Infection
  • Injury to spleen or liver (rare)
  • Cancer seeding – cancer spreading along the site of incision (rare)

Summary

Thoracentesis is an effective treatment to improve breathing and reduce pain for many pleural mesothelioma patients. When the procedure is performed by a mesothelioma specialist, the outcome is favorable. A 2010 study found that less than 2%  (three out of 225) patients who had thoracentesis with ultrasound guidance experienced complications.

If you are experiencing common mesothelioma side effects such as difficulty breathing and chest pain, please talk to your doctor about a thoracentesis.