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Has anyone out there had a pleurodesis

CCAOG
Posts: 31
Joined: Dec 2009

My Dr. says that I may have to have this procedure done. I understand the principal of how it works but would like to know how it makes you feel afterwards. Does it restrict your breathing in any way? Does it actually work? My breathing is allready restricted from the pleural effusion (fluid build up). Will they be able to get rid of the cancer cells in my lung by getting rid of the effusion? Am I looking at periodic Chemo the rest of my life? It seems as though the Doctors have pre-programed responses to these questions and, of course, it doesn't allways work out the way they say.

augigi
Posts: 89
Joined: Dec 2009

My mother had this done. It did relieve the shortness of breath from the pleural effusion. She had a lot of pain from the chest tube sites on her side. Now, she has a tumor on the skin at the chest wall where the tubes were - they said the cancer cells can "seed" along the tract where the drain tubes where.

She did feel like her breathing was "tight" or restricted after the pleurodesis was done - I guess that's how it works though.. sticking the lung to the pleura so fluid can't collect there.

Pleurodesis does not always work. Make sure you go to a surgeon who has done many and has a good track record. Good luck.

CCAOG
Posts: 31
Joined: Dec 2009

Thanks for your response. Could you tell me how long she was in the hospital? How bad is the tumor she got from it and can it be taken care of? I am a little skeptical about this procedure and any thing you can tell me will help me a lot in making the decision to have it done. I have only had my lung drained once and currently have more fluid in it now. This makes me feel like he may be jumping the gun on this procedure. I'm not really worried about the pain as much as is he doing something that not only might not work, but the damage it may give my allready weakened lung doing it. Any thing you could tell me will help an awful lot. I wish your mother the best and I will pray for the both of you. Thank you so much.

augigi
Posts: 89
Joined: Dec 2009

I think she was in hospital for 5 or 6 days, she did need some supplemental oxygen for a while because due to pain she didn't deep breathe very well and had some collapse in her good lung.

The tumor on her side, they are not worried about because she has so short a prognosis left. It is causing her a lot of nerve type pain and they considered doing radiation for that, but she doesn't want radiation due to the risks of side effects and further pain. She is using a pain patch (buprenorphine) which seems to be working reasonably well, although she cannot sleep on that side.

To be honest, I don't know how much or how often the fluid would have collected if she didn't have the pleurodesis. They did kind of rush her into it and I think she regrets getting it as she had so much pain with the chest tubes etc. May have been better off to just get the effusions drained when they happened, or to get a longterm thoracic drain which I have heard of some other people getting. It's a thin plastic tube into the space which collects the fluid, and then you just drain it as required. The pain she had, given that she only had a year or so left, wasn't really worth it for her.

CCAOG
Posts: 31
Joined: Dec 2009

I want to really thank you for the information. It really helps in the decision making process.

stayingcalm's picture
stayingcalm
Posts: 656
Joined: Feb 2007

I had this process done on January 13th to prevent further lung collapses - the pleurodesis went fine, and had no adverse effect on my breathing, don't be afraid of it.

I was in the hospital extra long because I have an air leak - my thoracic surgeon was going to try to find it and cut & stitch it out but it couldn't be found. So, I'm home with a Heimlich valve (a short tube that attaches outside the body to the chest tube and makes a lovely farting sound when I cough :)) and the hope that the leak may heal itself. Chest tube pain is manageable, I'm still taking Vicodin at night but I may stop that soon as I hate being dependent on pain meds.

agolsha2
Posts: 3
Joined: Feb 2012

I read the postings on this page the night before my mother's scheduled pleurodesis and I was really hesitant to go ahead with the procedure. However after speaking to her oncologist, respirologist, and thoracic surgeon, we (as a family) decided that she should have the procedure done.

She is 65 and her breast cancer from 10 years ago has returned and metastasized to her right lung. The symptoms were really bad coughs and severe shortness of breath. The fluid (pleural effusion) from the lining outside her lung was removed once by a needle. The fluid returned within 1 week and pleurodesis was recommended.

Her procedure had the following steps:

1) a chest tube was inserted under the right arm pit. This chest tube was used to drain the fluid and then to perform the chemical pleurodesis. Installing the chest tube was a very painful procedure for her because as soon as the fluid drained, the lung began to expand, which caused her to continuously cough. The nurses were really slow with giving her pain medication.

2) The chest tube continually drained for 2 or 3 days. Numerous x-rays were taken to compare and keep track of her progress.

3) The pleurodesis was done using talc, which apparently has a 90% success rating. We made sure they gave her enough local anaesthetic (due to the pain she had with the chest tube procedure). The procedure was fairly simple and painless.

4) A tube was again connected to drain fluid. And a suction was connected. This suction was to remain for 48 hours.

5) The nurses, at the surgeon's request, removed the suction after 24 hours. Immediately, my mom started blacking out and going dizzy. They reconnected the suction, which caused a lot of pain in her stomach. Later, we found that this pain was due to the lungs re-expanding.

6) She was still feeling dizzy and exhausted. We asked the nurse to check her oxygen, which turned out to be about 85 (anything less than 92 and oxygen should be given through the nose). As soon as they gave her oxygen, she started feeling better.

7) The suction remained for another 24 hours (total of 48 hours) and then was removed. An x-ray showed that her right lung was at 80% capacity, which the surgeon said is very good. She was discharged.

2 weeks have passed since her pleurodesis and literally everyday she is feeling better, has a clearer voice, and less shortness of breath.
She does have some pain when she takes deep breaths, but this side-effect was worth it. In her case, the benefits of remedying her symptoms far outweighed the pain involved with taking deep breaths.
What to take away from my experience: refer to a respirologist regarding this procedure. They know more about this than anyone else. If the respirologist recommends it, than don't think twice. Ask questions. Make sure the nurses give enough pain medication and check the vitals regularly.

We are very thankful of the team at TGH, especially Dr. Darling, for all they did for my mom.

daughter2t
Posts: 12
Joined: Mar 2012

My dad also had this procedure done @ TGH and i agree it did wonders for my dad. He is able to breath without all the pain and feels much better. How is your mom doing ?

agolsha2
Posts: 3
Joined: Feb 2012

I am happy to hear your father's procedure at TGH went well. I am guessing their thoracic surgeons may have been the same (Dr Darling and Dr Hanna).

My mom has been feeling better everyday since the procedure. She is back to work and things are going great. She has difficulty going up a flight of stairs or talking for prolonged periods, but that's to be expected. Occasionally, she'll have a bit of pain when taking a deep breath and her coughs are pretty bad. But I am very grateful, and lucky, to still have her around. At one point, it seemed very dark.

She's taking tamoxifen daily. And my dad makes her a special drink every morning which she hates but is supposed to work wonders. It's made by juicing one carrot, one apple, and one beet together. I've read in a few places about this drink and its effect on cancer. So far her tumors have shrunk a little, which is great news. She has another CAT scan in 2 months; we've got our fingers crossed.

agolsha2
Posts: 3
Joined: Feb 2012

how's your dad doing? keep in touch.

Booster24
Posts: 11
Joined: Apr 2012

I am 55 years old, a non-smoker and was dx with Stage IV lung cancer and pleural effusion in late March. Both my oncologist and the respiratory specialist recommended the Pleurodesis after 1 liter of fluid was drained from my lung.

They said there was a 90% success rate with this procedure and that it would help prevent a collapsed lung and remove the need to have fluid drained on a regular basis. I also went to a lung cancer specialist who said there was a possibility that cancer cells could get trapped as a result of the pleurodesis but after a survey of 3-4 oncologists, the consensus was that this possibility was just a theory.

I had the Pleurodesis done 6 weeks ago, was in the hospital for 2 days. The thoracic surgeon also did a pleurobiopsy so the tumor in my lung could be tested for EGFR mutation. All seemed to go well.

There was some pain for about 1 week after being released from the hospital, but that eventually went away. I can still "feel" the area, but it's more of a minor nagging issue than a real problem. And even that issue is slowly going away.

My breathing has improved,but I have noticed that when I sneeze or take a big yawn I sense that not as much air is being allowed in. Doc says that will improve over time.

I would recommend getting a couple of opinions from oncologists who specialize in lung cancer. And I would strongly recommend asking them who the best thoracic surgeon in your area is, and then interviewing them. I spoke to two, and the first one gave me some information which my oncologist debunked. The second one was more knowledgeable and was very well regarded by both oncologists so I went with him.

You're doing the right thing by seeking out more info. Keep going with that because you absolutely need to be comfortable in the decision you make. It's your body and your situation and you're the one in charge.

Best of luck to you. let us know what you do.

hempan307
Posts: 2
Joined: Jun 2012

Thanks all for sharing their and their loved ones experience on pleurodesis. My mother too is detected with a non-small-cell lung cancer stage IV and has been complaining to shortness of breath.

She has had fluid removed from the pleura about 4 times over a period of 2 months and then the thoracic surgeon recommended pleurodesis to avoid recurring pleural effusion. She got he pleurodesis done 3 days back and was kept in observation for 4-5 hours after which she was discharged from the hospital. However, the surgeon advised to have the tube under her arms to continue for atleast 24 hours.

Next day again we took her to the hospital and they took an x-ray to see the effusion basis which they removed the tube which was quite painful.

Coming back to pleurodesis, she still complains of shortness of breath and anxiety/ fear kind of symptoms which i feel is again due to short breath. She complains of pain in the chest at the time of coughing, sneezing, burping, deep breathing which I could see as a common effect from the treatment. Please help me as to how long it takes for the breathing symptoms to improve and is there any remedy for improving the shortness of breath problems. It is very painful for us to see her suffer because of this and her misery has still not gone even with the pleurodesis.

Please share your experiences as to the progress after the pleurodesis treatment as it will be comforting for all of us.

Thanks again.

Booster24
Posts: 11
Joined: Apr 2012

The first month following the procedure I experienced some of the same symptoms as your mother. They did subside. It is now two months and I have no pain, no shortness of breath. Only issue is minor, I have a little more phlegm coming up than was previously the case.

I can still "feel" the place where the procedure occurred but now it is more of a minor inconvenience than anything else. The pain I initially felt when sneezing or yawning has also subsided. It is not quite the same as before the Pleurodesis but it is no longer a problem.

I hope your mother has a similar progression, I think she probably will. This is a process and it will take a little time. Let us know how she's doing next month.

hempan307
Posts: 2
Joined: Jun 2012

Thanks Booster24 for your kind words. In fact the symptoms after the pleurodesis have now subsided with my mother as well. Its about one and half month now and theres no pain where the procedure was done. Just minor inconvenience as you mentioned.

On the other hand, she has been through 3 cycles of chemo now (Pemetrexed + Carboplatin) and some side effects are showing up now like stomach upsets, depression, lack of sleep. She is scheduled for a scan next week and hoping that there are improvements to be seen from all the treatments she is going through. Keeping fingers crossed.

Thanks again.

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