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Pleurodesis is a palliative procedure used to prevent pleural effusions in those suffering from several forms of end-stage cancer, including mesothelioma. The procedure works by inserting a tube into the chest cavity and introducing an irritant into the space between the lungs and the chest, effectively making the pleural cavity non-existent.[1]
Studies of MPM patients who have undergone pleurodesis indicate that the treatment can severely reduce the occurrence of effusions (water on the lung) and improve patient comfort factors.[2] However, the treatment does not improve survivability, instead merely acting as a symptom-relieving measure.[3]
Common substances used in pleurodesis include talc, the antibiotic tetracycline, and the anticancer drug bleomycin. At least some studies have established that all three are equally effective in treating malignant pleural effusions.[4]
Tetracycline
Tetracycline is an antibiotic that has possible therapeutic usage as a sclerosing agent for pleurodesis procedures — meaning the chemical can sufficiently scar the tissue to the extent that the pleurodesis will successfully eliminate the pleural cavity.
Use of tetracycline in pleurodesis has mixed results. One study saw a 23% failure rate after the procedure, indicating nearly a quarter of patients still developed a pleural effusion. Nevertheless, the study concluded that, “tetracycline pleurodesis using the powder obtained from the capsules is a simple and satisfactory palliation for malignant pleural effusion.”[5]
Another study found the use of a tetracycline poudrage to be, “an easy, safe, and effective method for performing pleurodesis.”[6]
Possible adverse effects include chemical burns.[7]
Bleomycin
Bleomycin is a cytotoxic (anticancer) drug commonly used for chemotherapy treatment.[8]
The drug has also been used as a sclerosing agent to aid in the pleurodesis procedure. Research has found the use of bleomycin to improve patient’s symptoms, although it does not improve their survivability.[9]
[1] https://www.cancervic.org.au/cancer-information/cancer-types/cancer_types/mesothelioma/treatment-mesothelioma.html
[2] http://jtd.amegroups.com/article/view/17694/html
[3] https://thorax.bmj.com/content/68/6/594
[4] https://thorax.bmj.com/content/65/Suppl_2/ii32
[5] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1790826/
[6] http://www.ejbronchology.eg.net/article.asp?issn=1687-8426;year=2016;volume=10;issue=2;spage=100;epage=104;aulast=Khalil
[7] https://academic.oup.com/ejcts/article/16/4/469/404206
[8] http://chemocare.com/chemotherapy/drug-info/bleomycin.aspx
[9] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3770504/
