How long can a Pleurx chest catheter stay in place?

JMM
Posts:5

Hello,

Can anyone share their experiences with an indwelling Pleurx catheter? Dear Husband had one placed rather urgently 6 weeks ago after two prior thoracentesis procedures about 3 weeks apart. The amount being drained 3x a week was going down for a while and is now trending upwards. Oncologist says that even when systemic treatment is working, the body can continue to create the effusions, requiring the drain to stay in long term.  I'm a bit overwhelmed by that thought and would like to hear from others who have walked this walk.

Thank you,
Joanne

JanineT GRACE …
Posts: 634
GRACE Community Outreach Team

Hi Joanne,

 

I'm sorry for not responding and wish someone with personal experience could respond.  Anyone out there in the forum closet want to chime in? 

Clinically, they can be left in place for as long as needed providing they are working properly.  Is he having any pain issues with it?  I don't know if you've done a search but this post and comments might be helpful.

 

Take care,

Janine

I joined GRACE as a caregiver for my husband who had a Pancoast tumor, NSCLC stage III in 2009. He had curative chemo/rads then it was believed he had a recurrence in the spine/oligometastasis that was radiated. He's 10 years out from treatment.

In reply to by JanineT GRACE …

JMM
Posts: 5

Hi Janine,

Thanks for the reply, I did search the site and found a few helpful posts and articles. The PleuRx is not causing pain, but we went from 0-60 with this disease in the first 6 weeks of this year and I had it in my head that the catheter would be a temporary thing -- as soon as the systemic therapy started, it would be removed and a certain level of normalcy would return (like being able to swim.) So, again, it is not causing pain, just some discomfort and a change in habits and perspectives. Since at the moment, it looks like taking it out may not happen, I would appreciate replies from anyone with experience with having a permanent indwelling catheter for malignant pleural effusions.

Joanne

JanineT GRACE …
Posts: 634
GRACE Community Outreach Team

I understand Joanne.  There are a million different ways to get thrown into the deep end of lung cancer and there's only so much understanding you can take in or find.  For my husband, it was horrible pain from a pancoast tumor, 2 needle biopsies and one VATS (video assisted surgery) that didn't capture any cancer cells though it was clear from the rib destruction and tumor that it was cancer but a biopsy is needed before anyone will start treatment. So he had a full on open thoracotomy.  Things I wish I'd known then...

 

One thing I would say is it's still early on and I would not assume they won't be able to remove it.  It sounds like he's a swimmer and I'm so sorry he can't.  Make sure his oncologist understands getting in the water is important, hopefully, they take your husband's wants as well as his needs into consideration.  If he is able to see an interventional pulmonologist, they specialize in this type of treatment and manage them every day and can give y'all an idea of what to expect and what options to consider to get him floating again. 

 

Jonathan (turkdoris) is trying to help his mom problem solve pleurex cath issues.  He may not read other threads and you could pop in on his thread here.

I joined GRACE as a caregiver for my husband who had a Pancoast tumor, NSCLC stage III in 2009. He had curative chemo/rads then it was believed he had a recurrence in the spine/oligometastasis that was radiated. He's 10 years out from treatment.

arm2966
Posts: 1
I am 57 and my wife is 59, despite working out And eating healthy food. My wife, margie was diagnosed with Adenoma carcinoma of the R/Lung with EGFR mutation by this time she was at stage 4 with 1400ML plural effusion They put a chest tube in put her on Tarceva and Cymraza/ WE hope f- friends her

Dear Joanne, My with had one installed in December, She needed it, she was putting out 850ML per day. with some much water leaving her i made her drink more and more water. margie was lucky. she responded miraculously. within 2 months of treatment, she was down to 100 ML Per day.. Now she is about 9ml. per day , But the pulmonary doctor said he wouldn't do anything until it was below 10ml per day for a month. then he went to 0 for a year. Now he is saying he wont remove it. Joanne have no doubt your Pulmonologist has a good reason. But Mine does not, He is waiting for my wife to die, he was a bit arrogant because he jumped the gun before they had a biopsy . i remember him standing there while my wife asked him how long she had to live"8 to 10 "months when we went to see the oncologist. very pleasant man. he said Margie. You Have An EGFR mutant gene. and we can treat with pills for that .Magie said why would i take that if ill be dead in 8 months he told her a lot of my patients have lived more than 6 years some 9 years-Now on yours..Joanne you can always get a second opinion from another pulmonologist.But he does have a hi flow sometimes and he is not having pain

we started with daily drains of 850ML from the chest tube.Daily. Ater 2 Months this was down too 80ML Per day.Then went weekly with weekly amount between an average of 4 to 11 ml daily 9ml, there is a significant amount of blood in the tube,margie is working out at the gym High impact sometimes 3 hours per day,sometimes she is so week she cannot get off of the couch.I suspect the blood is coming from her working out. , Margie and i would very much like your help if you can offer and we will do the same, AS you are on the same or similar journey.TheTarceva causes an overgrowth of certain bacteria that resemble acne.. If you have any advice please help us. e-,mail dday6698@aol.com
thanks,Alan

JanineT GRACE …
Posts: 634
GRACE Community Outreach Team

 Hi arm2966, Welcome to Grace.  I'm sorry your wife and you are going through this.  When my husband was diagnosed a surgeon told him he had maybe a year to live and I too remember that doc...sitting there on his 5 wheeled stool.  That was 15 years ago.  It affected my husband immensely and he still mentions it on occasion.  Our faculty oncologists are quick to say that they are notoriously bad at guessing how long someone will live.  I say, those who do and share with their patients should learn to keep their d... mouths shut or at least give a more accurate guess like 8 months or untill they die of something else many years from now. 

 

This video on side effects may help with skin side effects. 

 

From this old thread, Dr. West gives these comments about pleurex catheters, "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"

 

 

A consult with an interventional pulmonologist or interventional radiologist or just a different pulmonologist may help with understanding how much longer the pleurex catheter should remain because it may already be time.  Once out gym visits should be more comfortable.  The more she can not be reminded by trips to doc, catheters, infusions, etc the more daily life can feel more normal.  I wonder why it was decided to do tarceva and cymraza instead of osimertinib. 

 

I hope your wife does very well for a very long time.  Advances are happening so fast I can barely recognize treatments of today compared 15 years ago and it just keeps excelerationg. 

 

Best of luck,

Janine

I joined GRACE as a caregiver for my husband who had a Pancoast tumor, NSCLC stage III in 2009. He had curative chemo/rads then it was believed he had a recurrence in the spine/oligometastasis that was radiated. He's 10 years out from treatment.