Pleurodesis

The Abramson Cancer Center of the University of Pennsylvania
Last Modified: May 8, 2013

Question

Is there such a thing as dusting a person's lungs to try to build a "dam" to prevent fluid from building up?

Answer

Carolyn Vachani RN, MSN, AOCN, OncoLink's Medical Correspondent, responds:

The buildup of fluid in the lungs is called a pleural effusion. This fluid forms in the space between the actual lung and its lining, which is the area called the pleural space. A pleural effusion can be cancerous, but it can also be caused by other lung problems, such as infection (like pneumonia) or even heart failure. In most cases, the effusion causes people to feel short of breath because they cannot expand their lungs like they normally could before having the fluid buildup. Doctors use a technique called pleurodesis as one way to treat pleural effusions, which is what you are describing. The first method of treating an effusion is to put a needle (called a thoracentesis) or tube (called a chest tube) into the pleural space, which allows the fluid to drain out. Sometimes this is all the treatment that is needed, but oftentimes the fluid will come back. The technique you are talking about is called pleurodesis, and I would guess the "dusting" you are referring to is talc pleurodesis. Pleurodesis is performed after the fluid has drained through the chest tube (this may take several days). Then the "pleurodesing agent" is put through the chest tube into the lung. Although it is not well understood, the agent basically causes scarring in the pleural space, preventing the fluid from coming back. There are many agents that can be used to achieve this. The most common is talc (a powder-like substance) or chemotherapy drugs.