Thoracentesis

For pleural mesothelioma patients, a trusted, traditional treatment technique developed in the 1800s is still widely used as a treatment option. One of the primary symptoms of mesothelioma is pleural effusion, which is a buildup of fluid that surrounds the lungs. A wide range of pain and discomfort is associated with pleural effusion, which also severely affects a patient’s breathing. Thoracentesis is a procedure that will remove the fluid that has enveloped the space between the pleura and the lungs. It can also be used as a diagnostic tool for analyzing the extracted fluid in order to decipher the cause of the effusion.

There are several additional tests that a patient may have before the actual procedure. Most certainly, patients will have blood tests, a possible CT scan or ultrasound, and always a chest X-ray to clearly show the nature and extent of the fluid buildup.

Patients will have local anesthesia to numb the area of the chest where the needle will be inserted. Patients may experience a pressure sensation in the chest area, but no pain. This procedure can be completed as the patient is lying down or seated, as determined by their doctor. The 15-minute process will be complete when most or all of the excess pleural effusion has been removed. The fluid is then sent to a lab for analysis. A follow-up X-ray will be needed to verify that enough fluid was extracted and that there is no sign of a collapsed lung.

Benefits of a Thoracentesis

Having pleural effusion as a result of pleural mesothelioma causes many painful symptoms. Patients suffer from extreme feelings of pressure on the chest and lungs and constant shortness of breath. Undergoing thoracentesis as a treatment procedure will not necessarily cure the mesothelioma cancer, but it will elevate the associated painful symptoms while working to improve the patient’s quality of life.

Risks and Complications of Thoracentesis

Since this procedure involves the lungs, there is one serious risk of complication. Though extremely rare, a patient could experience a collapsed lung if the surgeon punctures the lung or disturbs a collection of air in the pleural cavity. A patient’s prior medical history will determine if there is a higher risk of complications before the procedure takes place.

If the patient has emphysema, asthma, or a history of other lung surgeries, or any condition that adversely affects blood clotting, then thoracentesis may cause more complications. Studies have determined that patients with pleural mesothelioma who benefit most from the procedure have less risk of experiencing a collapsed lung if the procedure is done using an ultrasound device. Another factor of complications is if the removed fluid is protein-poor (transudative) or protein-rich (exudative). Those patients with protein-rich pleural effusion have a higher risk of complications post-operation compared to those with protein-poor fluid. Asbestos related diseases most often produce exudative effusions (protein-rich).

Other major complications may include tumor seeding, lacerations to the liver or spleen, hemothorax, diaphragm injuries, and an accumulation of pus in the pleural cavity, known as empyema.