walker12
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When I was first diagnosed with a MPE, I was offered a talc pleurodesis that was to be the next morning at 6:00am. Because I am the kind of person that likes to think about stuff, I turned it down because I wanted to think about it. It was never offered again. That was a year ago. I still have the MPE and now it is causing me dyspnea and coughing. I now want a talc pleurodesis but my onc (new onc, previous onc left) prefers the pleurex catheter. Is it because a year has gone by and they don't think I'm going to live that much longer?
Should a person with stage 4 nsclc egfr + still get a talc pleurodesis if they are 14 months post diagnosis? Other than the MPE, I am doing well. Thank you
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Reply # - November 29, 2014, 07:12 PM
Hello,
Hello,
As Dr. West stated in his post on Options for Managing Recurrent Pleural Effusions pleurodeses "work best when the lung is well-expanded and can rest next to the chest wall after an effusion has drained," while
"A Pleurx catheter has the advantage of being useful when the lung can’t re-expand, and it also has the advantages of having minimal risk associated with it and a very short hospital stay, plus the frequency of draining can be tailored for each patient’s needs. On the downside, it involves an external catheter that some people don’t want to deal with, can potentially be a source of infection (up to around 5% of cases), sometimes can get plugged, and requires ongoing draining, while a pleurodesis involves no further interventions if successful."
It seems that a conversation with your medical team would be in order, to discuss the reasons for preferring a catheter in your situation.
JimC
Forum moderator
Reply # - November 29, 2014, 08:16 PM
Though there are a few
Though there are a few factors that might lead one to favor one approach over another, trends and personal preference are also a significant factor. Because the pleuRx can be removed if treatment is working well, we will still often use it in patients who are just being diagnosed and may do quite well. I have many patients who have done well for over a year, sometimes many years. As people get more comfortable with pleuRx catheters, I'm seeing fewer pleurodeses being done. And as Jim said, there are definitely some patients for whom a pleurodesis is unlikely to be helpful, such as if it seems the lung isn't re-expanding well after the fluid is drained.
Good luck.
-Dr. West