Mesothelioma Thoracentesis

Mesothelioma thoracentesis (also known as pleurocentesis) is a procedure that is used to drain pleural effusions (buildup of excess fluid in the lining of the lungs). It can ease common pleural mesothelioma symptoms, such as difficulty breathing. Learn how the thoracentesis procedure compares to other palliative treatments below.

Written and Fact-Checked by: Mesothelioma Hope Team

What Is Thoracentesis for Mesothelioma?

A thoracentesis is a common and simple medical procedure that can help patients with mesothelioma, a rare cancer caused by asbestos exposure.

Thoracentesis Definition

During a thoracentesis, the doctor inserts a hollow needle through the chest wall to drain pleural effusions.

Doctors may use a thoracentesis to:

  • Diagnose mesothelioma: Doctors can examine fluid that’s removed from the pleura under a microscope to see if mesothelioma cells are present, according to Cleveland Clinic.
  • Treat pleural effusions: Pleural effusions are a common condition in cases of malignant (cancerous) pleural mesothelioma. The fluid buildup causes pain and difficulty breathing. In many cases, doctors can easily drain a pleural effusion with a thoracentesis.

A thoracentesis is minimally invasive and a quick way to help patients get relief from their symptoms. Since it takes less than 30 minutes, it’s usually performed as an outpatient procedure (where the patient goes home from the hospital the same day).

Pleural mesothelioma patients can get a thoracentesis and other top treatments from cancer doctors. Find a mesothelioma specialist who can help you with our Free Mesothelioma Doctor Match.

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Paracentesis vs. Thoracentesis

A paracentesis is the same treatment as a thoracentesis, but fluid is drained from the abdominal lining (peritoneum) instead of the lung lining.

This makes paracentesis a good treatment for peritoneal mesothelioma. Specifically, it can treat a common peritoneal mesothelioma symptom called ascites, which causes bloating, pain, and nausea.

Your mesothelioma doctor can determine if a thoracentesis or a paracentesis would be better, depending on which type of cancer you have.

Steps for Getting a Thoracentesis for Mesothelioma

1. Initial Consultation and Imaging Scans

Oncology (cancer) doctors will typically recommend getting a thoracentesis if you have pleural effusions. During an initial visit to a doctor, you’ll be able to ask them questions and voice any concerns you have before agreeing to the procedure.

Your doctor may also recommend imaging tests, like X-rays or CT scans, to see exactly where the effusion is beforehand.

2. Thoracentesis Procedure

Once the pleural effusion has been located, thoracic surgeons (who treat ailments of the chest) can then begin the mesothelioma thoracentesis procedure. Cleveland Clinic notes that a thoracentesis usually takes just 15 minutes.

Here’s how doctors perform a thoracentesis:

  1. Prepare the patient: The patient may need to wear a hospital gown and be hooked up to machines that monitor their vital signs. If the patient requires oxygen during a thoracentesis procedure, they might receive a face mask or nasal tube.
  2. Get the patient into the proper thoracentesis position: Positioning for thoracentesis is very important in making the procedure go smoothly. Patients typically will need to sit upright or on their sides so doctors can easily access their back (which is where the needle will be inserted), according to Cleveland Clinic.
  3. Numb the skin: The doctor will apply a sterile numbing medicine to the skin.
  4. Insert the needle: Once the skin becomes numb, the health care provider will put the needle into the chest. An ultrasound is often used to make sure the needle is inserted properly. A 2022 report in the medical journal Diagnostic Cytopathology recommends that doctors use an ultrasound-guided thoracentesis if the patient has (or might have) cancer.
  5. Drain the fluid: The provider will use a tube that’s hooked up to the needle to drain the pleural effusion. The amount of fluid drained will depend on how much has built up. In a 2019 study from Cureus, a man had almost a gallon of fluid drained with a thoracentesis. He was later diagnosed with pleural mesothelioma.
  6. Perform fluid analysis: If the underlying cause of the pleural effusion isn’t clear, the doctor will conduct a biopsy using the thoracentesis sample. During this process, they’ll look at the pleural fluid under a microscope to see if cancer cells are present.

3. Mesothelioma Thoracentesis Recovery

After a thoracentesis for pleural effusions, the doctor will monitor the patient’s vital signs, including respiration, temperature, blood pressure, and heart rate. They may also provide a chest X-ray to make sure no complications have occurred.

Once the doctor deems that everything is OK, the patient can be discharged. The care team may also recommend that the patient take it easy for a few days following the procedure and limit any intense physical activity.

The average thoracentesis recovery time isn’t very long — most patients can remove the bandage from the incision site after a day. Patients should schedule a follow-up visit to make sure no complications have occurred.

Our Patient Advocates can help you access a mesothelioma thoracentesis and other top treatments. Contact us now.

Benefits of Mesothelioma Thoracentesis

For many patients, mesothelioma thoracentesis is a quick and effective way to treat pleural effusions and the symptoms they cause, such as breathing difficulties and chest pain.

A 2021 study published in the British Medical Journal looked at how thoracentesis could help patients with malignant pleural effusions.

This study revealed thoracentesis eased symptoms like:

  • Breathlessness
  • Cough
  • Pain
  • Sleeplessness

Another benefit of this procedure is that it can be performed multiple times with minimal risks to the patient if fluid builds up again in the pleural cavity.

Mesothelioma Thoracentesis Complications

Though rare, some patients may suffer from complications or side effects following a thoracentesis for mesothelioma.

Side effects of thoracentesis may include:

  • Bleeding
  • Blood or fluid oozing from incision site
  • Chest pain
  • Coughing up blood
  • Fever
  • Infection
  • Laceration to the liver, spleen, or lung
  • Pneumothorax (collapsed lung)
  • Shortness of breath
  • Tumor seeding (cancer spread if needle hits a tumor)

A persistent cough is another potential complication of thoracentesis. However, Memorial Sloan Kettering Cancer Center notes that this isn’t something to be concerned about and it typically goes away within an hour.

Patients should watch for serious complications as they recover and contact their doctor if any appear.

Does Thoracentesis Affect Mesothelioma Life Expectancy?

Mesothelioma thoracentesis is not known to significantly affect life expectancy, as it’s mainly used to ease symptoms and diagnose patients.

Doctors can recommend more aggressive mesothelioma surgical options or other treatments like chemotherapy for patients who want to improve their prognosis. Thoracentesis may be performed alongside these treatments to improve quality of life.

Learn about treatments that can help you live longer and with less pain in our Free Mesothelioma Guide.

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Thoracentesis vs. Other Palliative Mesothelioma Treatments

A mesothelioma thoracentesis is a palliative treatment, meaning doctors use it to reduce pain and discomfort. It’s helpful for those with early-stage cancer, as well as for late-stage patients with metastatic cancer (which spread through the body).

Thoracentesis may not be the best option to help patients suffering from frequent pleural effusions. Even though thoracentesis allows excess fluid to be drained, it does not prevent fluid from accumulating in the pleura again.

Learn about other palliative care options for pleural mesothelioma below.

Mesothelioma Thoracentesis vs. Chest Tube

An indwelling pleural catheter (IPC) or chest tube continually drains the pleura. As a result, the patient does not have to go back to the hospital for repeated thoracentesis procedures.

A PleurX catheter is often recommended for pleural mesothelioma patients who experience effusions that keep returning. This catheter allows patients to drain pleural effusions at home.

Thoracentesis vs. Pleurodesis

A pleurodesis is a surgical procedure that seals the lung lining to prevent future pleural fluid buildup, giving it an advantage over a thoracentesis since it is permanent.

Doctors seal the pleura by using medical-grade talc or causing mild irritation, which allows the lung to latch onto the chest.

Your mesothelioma doctors may recommend a thoracentesis, chest tube, pleurodesis, or another procedure depending on the nature of your case.

Find Out if a Mesothelioma Thoracentesis Is Right for You

If you or a loved one are interested in getting treatments like a thoracentesis for mesothelioma, we can help.

For over two decades, our team has connected mesothelioma patients and their loved ones with treatments, top doctors, and financial support. With our assistance, you can pursue a mesothelioma thoracentesis and other treatments to improve your prognosis.

Start your treatment journey right now using our Free Mesothelioma Doctor Match.

Mesothelioma Thoracentesis FAQs

How do you drain fluid from the lungs with mesothelioma?

A thoracentesis allows doctors to drain fluid from the lungs in cases of pleural mesothelioma. Using this procedure, they put a thin, hollow needle attached to a tube into the pleural space and remove the fluid.

Can fluid come back after thoracentesis?

Yes. Pleural effusions may recur (return) for some patients despite this treatment. In such cases, health care teams may recommend a pleurodesis, a catheter, or another palliative care option.

Some pleural mesothelioma patients may need multiple thoracentesis procedures performed, as pleural effusions can come back even if they’re drained.

How do you treat mesothelioma in the lungs?

Doctors can use a thoracentesis, major surgeries, and other treatments to help patients with malignant pleural mesothelioma (which is found in the lung linings).

Pleural effusions can cause uncomfortable symptoms like difficulty breathing and chest pain, which is why doctors often recommend using a mesothelioma thoracentesis to treat them.

Besides a thoracentesis, pleural mesothelioma patients must undergo aggressive treatments to remove the cancer from their body and live loner.

Mesothelioma Hope was founded by a team of passionate health advocates to educate people about this aggressive form of cancer. Mesothelioma affects thousands of people each year. Our team works tirelessly to give hope to those impacted by mesothelioma. Learn more about operating principles and our Editorial Guidelines.

References
  1. Argento, A. C., et. al. (2015). Patient-Centered Outcomes Following Thoracentesis. Pleura (Thousand Oaks, Ventura County, Calif.), 2, 2373997515600404. Retrieved April 4, 2023, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4708257/
  2. BD (Director). (2020, April 06). BD PleurX Drainage Catheter System: Dr. Lawrence Ruzumma Patient Testimonial [Video file]. In YouTube. Retrieved April 25, 2023, from https://www.youtube.com/watch?v=c7HKlj01Da8
  3. Cleveland Clinic. (2022, December 16). “Pleural Mesothelioma.” Retrieved April 25, 2023, from https://my.clevelandclinic.org/health/diseases/15044-pleural-mesothelioma
  4. Cleveland Clinic. (2022, October 3). “Thoracentesis.” Retrieved April 25, 2023, from https://my.clevelandclinic.org/health/treatments/24254-thoracentesis
  5. DeBiasi, E. M., et. al. (2015). Mortality among patients with pleural effusion undergoing thoracentesis. The European respiratory journal, 46(2), 495–502. Retrieved April 4, 2023, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4857137/
  6. Johns Hopkins Medicine. (n.d.). “Thoracentesis.” Retrieved April 4, 2023, from https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/thoracentesis
  7. Memorial Sloan Kettering Cancer Center. (2021, February 15). “About Your Thoracentesis.” Retrieved April 25, 2023, from https://www.mskcc.org/cancer-care/patient-education/thoracentesis
  8. Paquin, S.C., et al. (2019). “ 20 – How to Perform Endoscopic Ultrasonography-Guided Fine-Needle Aspiration,” Elsevier, 2019, Pages 250-260.e3. Retrieved April 4, 2023, from https://www.sciencedirect.com/science/article/pii/B9780323547239000208
  9. Penn Medicine. (2022, July 31). “About Pleural Effusion.” Retrieved April 4, 2023, from https://www.pennmedicine.org/for-patients-and-visitors/patient-information/conditions-treated-a-to-z/pleural-effusion
  10. Rakhra, A., et al. (2019, February 19). Cureus. “A Rare Case of Malignant Mesothelioma Presenting with Systemic Lupus Erythematosus Seropositivity: A Case Report and Review of Literature.” Retrieved April 25, 2023, from https://www.cureus.com/articles/17796-a-rare-case-of-malignant-mesothelioma-presenting-with-systemic-lupus-erythematosus-seropositivity-a-case-report-and-review-of-literature#!/
  11. Shaker, N., et al. (2022, September 07). Diagnostic Cytopathology. “Cytology of malignant pleural mesothelioma: Diagnostic criteria, WHO classification updates, and immunohistochemical staining markers diagnostic value.” Retrieved from April 25, 2023, from https://onlinelibrary.wiley.com/doi/full/10.1002/dc.25053
  12. St. Vincent’s Hospital Lung Health. (n.d.). “Pleurodesis.” Retrieved April 25, 2023, from https://www.svhlunghealth.com.au/procedures/procedures-treatments/pleurodesis
  13. Twose, C., et al. (2021, January 8). British Medical Journal. “Therapeutic thoracentesis symptoms and activity: a qualitative study.” Retrieved April 25, 2023, from https://spcare.bmj.com/content/early/2021/09/26/bmjspcare-2020-002584/
  14. University of Rochester Medical Center. (2023).“Thoracentesis.” Retrieved April 25, 2023, from https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=92&contentid=p07761

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