New Methods for Treating Pleural Effusion

Mesothelioma is a cancerous disease that primarily affects the cells that line the lungs and peritoneum. Mesothelioma is often attributed to exposure to asbestos fibers through work sites or products containing asbestos. The delayed onset of symptoms, or latency period, can be as long as 20 years after exposure.

Pleural effusion is a common and debilitating side effect of mesothelioma, which can have a major impact on a patient’s quality of life. Fluid is normally found between the chest cavity and the thin membranes that surround the lungs. Pleural effusion occurs when the fluid buildup becomes excessive and can result in a person’s inability to breathe freely, cause chest pain and feel a general sense of fatigue.

Pleurodesis is a hospital-based treatment that some patients elect to use for pleural effusion. The process involves medical treatment that causes the lining of the lungs to stick together, thereby eliminating the space where fluid buildup may occur. While this process has been shown to repair the problem and relieve symptoms, it is an invasive and costly procedure.

A new study from the Netherlands has shown the cost-reducing effectiveness of indwelling pleural catheters (IPCs).  The study found that the procedure for placing the catheters to be less expensive than pleurodesis treatment and its resulting hospitalization. One of the benefits of IPCs is that their placement is often done during an outpatient procedure and can be maintained with at home care.

During an outpatient procedure, the doctor will place this small catheter between the linings of the lungs in the chest wall cavity. The drainage tube is often well-tolerated and can be easily drained by the patient at home as often or as little as is needed. The IPC is intended to remain permanently but can be removed if necessary during an outpatient visit.

While mesothelioma can be a painful illness to cope with, the hope of this and other research studies is to help reduce to the suffering of painful side effects.

Understanding Pleural Effusion in Mesothelioma Patients

Pleural effusion happens when fluid builds up in the pleural cavity (the thin space between the lungs and chest wall). In mesothelioma, this often occurs because cancer cells irritate or block the pleura’s ability to drain fluid normally.

Common Symptoms Include:

• Shortness of breath and chest tightness
• Persistent cough or hoarseness
• Fatigue, fever, and reduced mobility

Doctors typically diagnose pleural effusion using imaging tests (CT, MRI, or PET scans), followed by thoracentesis to analyze fluid for malignant cells. Early identification can relieve symptoms and guide treatment decisions.

Advances in Image-Guided Thoracentesis

A decade ago, thoracentesis procedures were often done “blind,” with physicians estimating where to insert the needle based on physical cues. Today, things look very different.

A patient with mesothelioma may now undergo an ultrasound-guided thoracentesis in an outpatient setting. The physician uses real-time imaging to pinpoint exactly where fluid has pooled, which can dramatically lower the risk of lung puncture.

Compared to traditional methods, image-guided thoracentesis offers:

• Greater safety: Fewer complications such as pneumothorax or bleeding.
• Faster recovery: Most patients return home the same day.
• Improved diagnostic yield: Clearer visualization ensures better fluid sampling.

This simple shift from estimation to visualization has reshaped how mesothelioma symptoms are managed in hospitals worldwide.

Combining IPCs with Targeted Therapy

Can Indwelling Pleural Catheters (IPCs) be Used With Cancer Treatments?

Yes. Oncologists are increasingly combining IPC drainage with targeted therapies and immunotherapies to control both tumor growth and fluid buildup.

How does this help patients?

• Some chemotherapeutic agents can now be administered directly through the IPC into the pleural cavity.
• Immunotherapy drugs such as pembrolizumab may enhance the body’s immune response in the pleura, reducing recurrence.
• This dual approach limits hospital stays and allows patients to continue daily life with fewer interruptions.

This personalized care model turns IPCs from a simple drainage tool into part of an integrated cancer management strategy.

Monitoring and Managing At-Home Care for IPCs

For patients using indwelling pleural catheters at home, self-care and hygiene are key to preventing infection or complications.

Daily & Weekly Checklist:

• Wash hands thoroughly before handling the catheter.
• Drain only when fluid buildup causes discomfort or as instructed by your doctor.
• Keep the site dry and covered with sterile dressings.
• Watch for signs of infection (redness, swelling, or fever).
• Log drainage amounts to share with your healthcare team.

Routine follow-up visits help ensure the catheter remains functional and that fluid accumulation stays under control.

The Future of Pleural Effusion Treatment

The treatment of pleural effusion is moving beyond simply draining fluid, it’s entering an era of precision medicine. Researchers are exploring new frontiers like gene-based therapies, nanoparticle drug delivery, and even AI models that predict recurrence before symptoms appear. The goal is no longer just symptom relief; it’s long-term control with minimal invasiveness. The more science advances, the closer mesothelioma patients come to managing pleural effusion as a chronic condition rather than a daily struggle.

For more information on other medical advancements please be sure to see other articles currently listed on Cooney and Conway’s blog to learn more.