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Mesothelioma Thoracentesis (Pleurocentesis)

Thoracentesis, also called pleurocentesis, is a minimally invasive outpatient procedure you may encounter in your mesothelioma treatment plan if you have been diagnosed with pleural mesothelioma. Physicians often use thoracentesis to diagnose the cause of fluid building up in the lining of the lungs (pleural effusion). However, it can also be used as a treatment to improve quality of life for some patients with pleural mesothelioma.

What Is Thoracentesis/Pleurocentesis?

Thoracentesis is a medical procedure in which a surgeon inserts a tube or needle into the patient’s side to extract fluid from the pleural cavity – the thin space between the two pulmonary pleurae of the lungs. This space is naturally filled with fluid to lubricate lung expansion. An excess of fluid in this space, however, can compress the lungs and hinder breathing. Pleural effusion is often tied to advanced stages of pleural mesothelioma. It can also stem from other forms of cancer, as well as pneumonia, pulmonary embolism and congestive heart failure.

As a treatment for pleural mesothelioma, thoracentesis can remove the excess fluid to allow the lungs to expand more normally. This can improve a patient’s ability to breathe and his or her related quality of life. It is not a curative treatment for mesothelioma and will not typically increase life expectancy. As a means of diagnosing a patient, a doctor may test the fluids extracted during thoracentesis/pleurocentesis to identify the underlying cause. In some cases, the underlying cause remains unknown.

If your doctor recommends thoracentesis as a palliative treatment for mesothelioma, it means you have pleural effusion that could be contributing to symptoms such as chest pain, trouble breathing, shortness of breath and coughing. The extra fluid may be pressing on your lungs and causing or worsening these uncomfortable symptoms. Your doctor may believe thoracentesis could improve your quality of life by bringing your fluid levels back down to a normal level.

What Happens During a Thoracentesis Procedure?

During this outpatient procedure, you will sit in an upright position on an exam table or hospital bed. The doctor will use a numbing agent to make the procedure more comfortable. Then, your doctor will insert a hollow needle between your ribs to access the pleural space. You should feel minimal pain at insertion and during the procedure. The doctor may remove the excess fluid using the hollow needle or by inserting a larger tube, depending on the amount of fluid. Your doctor may recommend a short hospital observation period, but most patients are free to go home directly after thoracentesis. You may need a caregiver to drive you.

Are You Eligible for Thoracentesis?

Doctors recommend thoracentesis as a low-risk treatment option for most people suffering from pleural effusions, both from malignant mesothelioma as well as other causes. First, your doctor will use an x-ray scan to view the chest cavity and confirm an excess of fluid in the pleural cavity. Then, your doctor will either perform the thoracentesis the same day or schedule a follow-up appointment. Thoracentesis takes about 10 minutes to complete. Some patients require more invasive follow-up procedures for severe pleural effusions or fluid that recollects shortly after thoracentesis. One procedure is pleurodesis, which drains the pleural space and then seals it to prevent future buildups.

If you struggle with symptoms of mesothelioma that impact your ability to breathe, ask your doctor about thoracentesis. The benefits of this palliative procedure could include the ability to fully expand your lungs again, along with less tightness in your chest and easier breathing. Recovery time is minimal for this outpatient procedure, with no stitches necessary. Unless otherwise instructed by your doctor, you can return to normal activity at home. You should avoid strenuous physical activity for the first few days after the procedure, however. With minimal risks and a high rate of success in relieving common symptoms of pleural mesothelioma, thoracentesis might be the right treatment option for you.

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