Clapper, Patti, Schweizer and Mason

In most cases where malignant pleural mesothelioma, a cancer that begins in the lining of the lung, is diagnosed, thoracentesis is the first step toward not only verifying the diagnosis but also relieving painful symptoms.  One of the main symptoms of mesothelioma is pleural effusion, a painful build-up of fluid between the layers of the pleura that line the lungs and inside of the chest cavity. 

Pleural effusion is often experienced as chest pain, dry cough, shortness of breath, and/or difficulty breathing.  Several methods are used to evaluate pleural effusions:

·         CT Scan (computed tomography scan) of the chest

·         Xray or Ultrasound of the chest

·         Thoracentesis

·         Analysis and examination of pleural fluid

·         Thoracoscopic surgery (also referred to as VATS – video assisted thoracoscopic surgery)

Thoracentesis is one diagnostic procedure where a needle is inserted between the ribs and into the pleural cavity to retrieve a sample of fluid.  During this time, palliation of fluid build-up can also be performed, helping to relieve symptoms of lung constriction.

If the cancer has progressed to the point where it is compressing the lung and fluid removal does not lead to increased expansion, then other long term treatment options for palliative care will be introduced as thorancentesis will be ineffective at providing symptom relief.

In some cases, serial thorancenteses will be recommended as part of a systemic treatment, however such a plan is rare as other risks are created with repeated procedures.  Consult with your medical team to discuss all possible palliative options that are best suited for your particular stage and type of mesothelioma.