Anyone here had a pleurodesis...?

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Best wishes,

From the Mods

Hi Annie,

I was also rediagnosed with a large right pleural effusion. They did a thoracentesis but the fluid quickly returned. At that point they inserted a PleurX Catheter to allow the lung to be drained at home twice a week. You should ask your MO about this option. It took about six months but ultimately I experienced a spontaneous pleurodesis and the fluid dried up more or less. I still have pockets of loculated fluid but it doesn’t bother me much. It’s my understanding that the pleurodesis procedure is not always successful so this may be an option.

It does require out patient surgery and it was a bit painful for a few days after but the relief to my breathing was fabulous. You would need to be careful in terms of possible infection but that is not difficult to overcome. But your MO may be hoping that you will get relief once the Letrozole kicks in. Hormone therapy generally ilicits a slower response but are great once things start to respond.

Hope your meeting with your MO goes well and things with your lung improve quickly.

Hugs.

Annie, I hope this information about the three options for draining pleural fluid from my book, "The Insider's Guide to Metastatic Breast Cancer" reaches you in time for your doctor visit.  T(he book is available on Amazon in paperback and eBook formats, or in .pdf format free of charge by emailing me at bestbird@hotmail.com   )

For
patients who have pleural effusion, there are three methods of draining the
fluid to provide relief:

Indwelling (Pleurx or Aspira) Catheter: This is the surgical insertion, under general
anesthesia, of a small tube placed temporarily into the pleural space that
allows the patient or his/her family member to drain the fluid into a bottle as
needed.  Patients with an indwelling catheter
are fully mobile and are not “attached” to the draining bottle except when
draining the fluid.  Once there is no
more drainage at all, the catheter is removed either in the doctor’s office or
an outpatient procedure.  Overall,
indwelling catheters seem to help prevent the fluid from building up again,
provided that the patient’s systemic treatment is working.  The Pleurx catheter works via suction, and
the newer gentler model is the Aspira catheter, which is a bit less
uncomfortable because uses gravity instead of suction for draining. 

Pleurodesis (sometimes
referred to as a “talc procedure”) is a process in which substances, such as
talc, are used to try to get the edge of the lung to stick to the chest wall to
decrease the chance of the fluid returning. 
Although this procedure seems to help prevent the fluid from building up
again (provided that systemic treatment is working) it can be painful and
usually requires a brief hospital stay. 
Some patients have reported discomfort months and even years after the
procedure.  In rare cases, the procedure
may fail altogether, rendering it impossible to drain the fluid thereafter
because it becomes trapped in a honeycomb of many small pockets (called
“loculations”).  Of all options for
draining malignant pleural effusion, this appears to be the most risk-prone.

Thoracentesis
(sometimes
referred to as “tapping”)is an
outpatient procedure thatinvolves
placing one needle per required side into the pleural space.  Although local anesthesia is administered,
this procedure can be uncomfortable and may cause scarring if repeated over
time.  The procedure also does not hinder
fluid buildup again.  These tips may make
the procedure less uncomfortable: 1) 
Request a numbing agent before the needle is inserted to feel more
comfortable after the procedure. 2) Request that the fluid to be withdrawn
slowly in order to avoid low blood pressure or a “fainting” feeling afterwards.
3) Lean forward with a soft pillow supporting your head and upper torso while
the draining is underway via your back.