[breadcrumb]
The vast majority of mesothelioma patients experience trouble breathing, which is a symptom of a condition known as a pleural effusion. A pleural effusion can be found in 70% of mesothelioma patients upon presentation of initial symptoms.[1]
Pleural effusions occur when fluid is trapped in the cavity in between the lungs and the pleura or the pleura and the chest.[2] This symptom occurs frequently among mesothelioma patients because the tumor tissues can trigger the accumulation of fluid while at the same time preventing its drainage.
A talc pleurodesis aims to prevent recurring pleural effusions in mesothelioma patients by eliminating the space between the pleura and the chest cavity entirely.
To perform a talk pleurodesis, a surgeon first makes an incision to drain the excess fluid contained within the pleural membranes. Then, the surgeon will inject a mixture of talc mineral and other substances through a chest tube. The substance is allowed to remain for about two hours.
If the patient is having the procedure administered in a hospital room, they will likely be awake for the procedure and asked to change positions every 30 minutes.[3] They are given a self-administered anesthetic to manage the pain.
The chemical slurry causes irritation and scarification of the surrounding tissues.[4] While this may sound unpleasant, what it does in effect is to eliminate the pleural space entirely.
Research of talc pleurodesis outcomes shows the procedure to be highly effective at eliminating pleural effusions. Results from one review of trials showed that the procedure had a significantly higher success rate compared to control therapies with a similar rate of adverse events.[5]
An alternative method for this procedure, referred to as thoracoscopic pleurodesis, has a similar effectiveness rate but a higher risk of complications.[6] A review of talc-based methods found them to be preferable in nearly every instance.[7] One study even determined that the common talc powder sold in grocery stores could be used to safely perform the procedure, in some instances.[8]
Positive results notwithstanding, a talc pleurodesis is not without its risks or side effects. Patients will need to heal from the incisions made, risking infection and leading to pain. A small number of cases have also raised concerns that the talc could become partially distributed by the body and interfere with kidney functioning.[9]
[1] https://err.ersjournals.com/content/25/142/472
[2] https://my.clevelandclinic.org/health/diseases/17373-pleural-effusion-causes-signs–treatment
[3] https://www.uwhealth.org/healthfacts/surgery/5847.html
[4] https://www.uptodate.com/contents/talc-pleurodesis
[5] https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0087060
[6] https://www.ncbi.nlm.nih.gov/pubmed/17309178
[7] https://www.atsjournals.org/doi/full/10.1164/ajrccm.162.6.pc09-00a
[8] https://journals.lww.com/bronchology/Fulltext/2004/10000/Talc_Pleurodesis__Easy_Alternative_Solution.2.aspx
[9] https://journals.lww.com/bronchology/FullText/2006/10000/Talc__Is_it_Safe_.2.aspx
