Pleurx Catheter Placement Experience

Portal Forums Cancer Treatments / Symptom Management Patient Experiences Pleurx Catheter Placement Experience

This topic contains 8 replies, has 5 voices, and was last updated by  Dr West 1 year, 9 months ago.

Viewing 9 posts - 1 through 9 (of 9 total)
Author Posts   
Author Posts
March 6, 2013 at 2:21 pm  #1254521    

meanie11

Hi Gracers, I was wondering if anyone can tell me your experience with Pleurx catheter placement for pleural effusion. My mom just got the catheter yesterday and she is in pain, coughing and continues to have SOB (shortness of breath)….I was wondering if this is usually the norm? Do the patients have immediate benefits from SOB once the catheter is placement in the chest cavity and liquid is drained or does it take a few days for the lungs to adjust to the catheter? Also, how often does one have to drain the fluid (i.e., daily, weekly, bi-weekly, etc)? THANK YOU

March 6, 2013 at 7:13 pm  #1254524    

Dr West

It’s not typical to have pain, and shortness of breath typically improves significantly once the fluid is drained, as long as the lung re-expands. Sometimes the lung is “trapped” because there may be fibrous material, possibly cancer, limiting the lung from re-expanding even when there isn’t compression of the lung from fluid outside — in that case, the shortness of breath wouldn’t typically improve, or at least not much.

How often the fluid needs to be drained is completely individual, dependent on how much fluid the cancer is making. Some patients may need to drain the fluid every day or two and remove 500-1000 cc at a time. Other people will have relatively little fluid production and may only need to be drained every week, or even less frequently. however, if the fluid reaccumulates very slowly, we sometimes take out the catheter and just insert a needle to do a thoracentesis here and there when needed.

Good luck.

-Dr. West


Howard (Jack) West, MD
Medical Oncologist

Views expressed here represent my opinion, not those of GRACE or Swedish Cancer Institute. This information does not constitute medical advice and is intended to supplement and not replace medical information provided by your doctor.

March 8, 2013 at 12:23 pm  #1254552    

meanie11

Thank you so much Dr. West.

March 11, 2013 at 9:49 pm  #1254647    

laya d.

meanie11:

My Mom had very little pain from the catheter itself, but had pain when they would drain the fluid. It was explained to us that there are a lot of nerve endings in the pleura. . .so there is a pressure/pain feeling if they drain too fast or too much at once (a vacuuming sensation). It’s best to go slow (keep your thumb on the little switch-thingy and pace it slowly) – – even start stop start stop…etc. There shouldn’t be a rush to get the fluid out as quickly as possible. Do it over a 15-20 minute period of time (for 300-400 ccs). Your Mom can tell when she starts feeling super uncomfortable and you guys should stop.

Good luck,
Laya

P.S. My Mom took some tylanol or advil about 15-20 minutes before we drained her. She said it helped with the draining pain. Of course, check with your Mom’s doc first about any meds. for her.


1/10 – My Mom (58) dx w/ NSCLC-Adeno 3a; 1 cycle of neoadjuvent Carbo/Alimta before finding out EGFR+ (Ex. 19), then switched to 7 wks of neoadjuvent Tarceva/150 mg (major shrinkage); 4/10 – right pneumonectomy; 6/10 started 3 rounds of adjuvent Cis/Alimta w/ concurrent chest radiation (7 wks); 8/10 – NED; 11/10 – small nodule in left lung; 1/11 – 3 small nodules in left lung, start Tarceva/100 mg; 4/11 – suspected sclerotic met to hip, continue w/ Tarceva, add XGEVA, brain MRI clear; 9/11 – solitary 3 cm met (adeno w/ T790m mutation) to cerebellum, surgery and gamma knife, up Tarceva to 150 mg; 11/11 – 2 left lung nodules growing, biopsy on 1 shows mutation from adeno to squamous (shocker!), brain MRI clear, continue Tarceva & Xgeva; 2/12 – brain MRI clear, CT scan, remaining nodule slightly bigger – – monitor for now, Tarceva (reduced to 100 mg) & Xgeva continued; 4/12 progression and rebiopsy (confirmed adeno), stop Tarceva, switch to Carbo/Alimta; 6/12 maintenanceAlimta; 8/12 back to Tarceva; 10/12 Gemzar; 11/16 difficulty breathing; 12/12 hospice initiated…my Mom passed away peacefully on 12/19/12. Heartbroken.

March 13, 2013 at 4:49 pm  #1254739    

aunttootsie001

Laya thanks for the info. It looks like I’ll be getting one put in very soon! I was leaning toward the Talc procedure but from what I have heard a lot of time it doesn’t work and then they have to do Catheter anyway. I had mine drained once in Oct. and then about 2 weeks ago and wasn’t expecting to need it again for 3 or 4 months but for some reason it filled back up in 2 weeks. So had it drained yesterday and already I can tell it is filling up again. Of course no pain when they do it but that is because he gives a shot before inserting the Needle. One more reason to still go for the Talc procedure. Any pros and cons anyone? Lorrie.


DX June 2011, Non smoker. Lobectomy August. 2011. Two TX Carbo/Taxol. 31 TX Radiation 2012. Break no treatment 8mo. Malignant Pleural Effusion discovered Oct. 2012. Xalkori started Nov. 2012. Pleurodisis done April 2013. Last CT still NED.

March 13, 2013 at 5:18 pm  #1254742    

Dr West

Talc: pros — when it works, it’s one and done. Cons — temporarily causes pain, fever, inflammation in most patients, doesn’t work all the time. Isn’t suitable if lung doesn’t reinflate well when fluid is removed.

PleuRx: pros — can be managed by patient and/or caregivers at home and have fluid removed on demand, can be removed if it resolves because of effective treatment of underlying cancer; cons — some risk of catheter infection, catheter can get clogged; losing fluid over and over can lead to significant protein loss and increased risk of infection due to diminished immune function over time. Not ideal as long-term solution.

Repeat thoracenteses: pros — done on demand only, no more than needed; cons — some increased risk of pneumothorax (lung collapse) and/or bleeding when needle introduced over and over, same issue of long-term protein loss with removal of large volumes of fluid over time.

Good luck.

-Dr. West


Howard (Jack) West, MD
Medical Oncologist

Views expressed here represent my opinion, not those of GRACE or Swedish Cancer Institute. This information does not constitute medical advice and is intended to supplement and not replace medical information provided by your doctor.

March 13, 2013 at 5:45 pm  #1254746    

JimC Forum Moderator

Dr. West also wrote a post on management of pleural effusions a while back: http://cancergrace.org/lung/2007/03/18/mpe-managment-options/

JimC
Forum moderator


Jul 2008 Wife Liz (51/never smoker) Dx Stage IV NSCLC EGFR exon 19
4 cycles Carbo/alimta, 65% shrinkage
Tarceva maintenance
Mar 2010 progression, added Alimta, stable
Sep 2010 multiple brain mets, WBR
Oct 2010 large pericardial effusion, tamponade
Jan 2011 progression, start abraxane
Jun 2011-New liver, brain mets, add Tarceva
Oct 2011-Dx Leptomeningeal carcinomatosis; pulsed Tarceva
At rest Nov 4 2011
Since then: http://cancergrace.org/blog/jim-and-lisa

March 13, 2013 at 9:39 pm  #1254748    

meanie11

Thank you so much for your post Laya. My mom was having too much discomfort with the pleurx catheter and was not getting any sleep. We ended up taking her to the ER when she started to have difficulty urinating and bloated stomach. My mom had a trapped lung on the side where the catheter was placed. After connecting a suction to the catheter to see if her left lung would reinflate, it was determined that her left lung is permanently collapsed due to the cancer and etc. My mom also had a moderate pleural effusion on her right lung and they did a thorencentesis and drained about 1 liter. She was finally discharged yesterday after spending 5 days at the hospital. She is so weak and has a bloated stomach and swollen legs. I have a feeling this is due to lack of movement and her large liver metastases. She is scheduled to have radiation to her large liver met but she has said that she is too weak. Would radiation to the large liver met (38x93mm) relieve the pain and the bloated stomach and feeling of fullness? Would the radiation be of any benefit? Thank you.

March 13, 2013 at 9:43 pm  #1254750    

Dr West

Honestly, it’s hard to say if it would help. It might, but with so much going on, and with results from radiating of liver mets being not especially common, I think it would be hard to predict if it will help significantly or not. Good luck.

-Dr. West


Howard (Jack) West, MD
Medical Oncologist

Views expressed here represent my opinion, not those of GRACE or Swedish Cancer Institute. This information does not constitute medical advice and is intended to supplement and not replace medical information provided by your doctor.

Viewing 9 posts - 1 through 9 (of 9 total)

You must be logged in to reply to this topic.