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plural effusion

Posts: 3
Joined: Jun 2007

I am caregive for my partner who was diagnosed in Jan 07 with poorly differentiated neuroendocrine carcinoma. He received 10 days back to back radiation followed immediately by chemo - Carboplastin iv and 5 days of etoposide. He was responding wonderfully and gained weight but developed a DVT in his right leg after the forth monthly chemo and now has plural effusion wich is non ca but he is extremely poorly and had both lungs drained and still unable to breath without constant oxygen. Is there anyone here that has been through this that can share their experience and give us some hope. He is scheduled for a procedure called pluradesis (spelling!) which is injection talc substance into the plural cavity to glue them together and dry up the fluid but he is exhausted and loosing faith. What kept Ray going intially was his determination and positive attitude which alas has faltered now due to present condition.

Posts: 1048
Joined: Aug 2006

An acquantance of mine had it done and said that the talc was supposed to irritate the lung lining tissue so it heals together. That keeps the fluid from returning. They tried just draining her lungs but that wasn't enough. Apparently it worked for her. Hope it works for your dad too.

Posts: 3
Joined: Jun 2007

ty 4 that

Posts: 2
Joined: Mar 2009

My husband had the procedure where they attach the lung to the chest wall.(pleuradesis). He is not filling up. It worked great!!

gdpawel's picture
Posts: 525
Joined: May 2001

University of Florida researchers reported that talc has the ability to stunt cancer growth by cutting the flow of blood to metastatic lung tumors. Their study, published in the European Respiratory Journal, revealed that talc stimulates healthy cells to produce endostatin, a hormone considered the magic bullet for treating metastatic lung cancer. The researchers say talc is an exciting new therapeutic agent for a cancer largely considered incurable.

Talc causes tumor growth to slow down and actually decreases the tumor bulk. Talc is able to prevent the formation of blood vessels, thereby killing the tumor and choking off its growth. The tumors appeared to grow much slower and in some cases completely disappeared.

Scientists have only recently discovered that talc stunts tumor growth, though the mineral has been used for almost 70 years to treat the respiratory problems that accompany metastatic lung cancer. about half of all patients accumulate fluid around the surface of the lungs, a condition known as malignant pleural effusion. That fluid can press down upon the lung, impair the breathing of the patient and cause the patient to feel very short of breath.

Pleural effusions indicate that the cancer, which might have started in the breast, lung, or gastrointestinal tract, has spread throughout the body. The prognosis for the roughly 200,000 patients afflicted with this condition is poor: Many die within six months.

To make life more bearable for these patients, doctors close the extra space between the lung and the chest wall, where the troublesome fluid collects. The trick is gluing the two surfaces together. Talc is blown into the patients' chest cavity to irritate the tissue and create tiny abrasions. When the lung tissue heals, it becomes permanently adhered to the chest wall without impairing the patients' breathing. The effects of the procedure, called medical thoracoscopy with talc pleurodesis, are immediate and last a lifetime.

The procedure has been used very extensively in Europe but it's had slower acceptance in the United States, perhaps because of the need to learn a new technology. The Food and Drug Administration approved talc for use in medical thoracoscopy in 2003, but UF is one of just a handful of U.S. institutions that perform the outpatient procedure on a routine basis.

Doctors have noticed that patients who undergo medical thoracoscopy with talc live up to 18 months longer than expected. The UF researchers were surprised to find that talc has added benefits besides causing scarring and taking away the fluid that surrounds the lung. The cells that cover the lining of the lung are stimulated by the presence of talc to produce a factor that inhibits the growth of blood vessels and kills the tumor cells themselves.

Less than one day after treatment with talc, patients began producing 10-fold higher levels of endostatin, a hormone released by healthy lung cells. Endostatin prevents new blood vessels from forming, slows cell growth and movement, and even induces nearby tumor cells to commit suicide. All of these make it hard for tumors to grow and spread into healthy lung tissue.

When endostatin was first discovered in 1997, doctors hoped its tumor-fighting properties would lead to a cure for cancer. But clinical trials have been disappointing, possibly because most clinicians have injected the hormone directly into patients. The hormone breaks down in the body before it has a chance to slow the spread of cancer.

What they've done is caused the normal pleural mesothelial cells to continue to produce endostatin. Talc doesn't go away. Talc stays in the chest cavity, constantly causing the normal cells to produce this factor that inhibits the growth of the tumor. The antitumor effects of talc appear to be long-lasting, and they are continuing to investigate the long-term outcomes of patients who have undergone talc pleurodesis.

I can understand the disbelief that endostatin clinical trials had been disappointing, possibly because most clinicians had injected the hormone directly into patients, where the hormone broke down in the body before it had a chance to slow the spread of cancer. But researchers like Dr. Veena Antony "rethought" the situation by understanding that by allowing talc in the chest cavity, thus constantly causing the normal cells to produce endostatin, may inhibit the growth of tumors.

Thanks to scientists like Dr. Antony that took the time to think through "whiz bang" science that often gets a pass without much thought. The problem is that few scientific discoveries work the way we think and few physicians/scientists take the time to think through what it is they're discovered. I genuinely believe that there is more to Talc poudrage than is commonly recognized. Perhaps because it is easily available and cheap, and it has not had the press it deserves!!

SOURCE: University of Florida


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