Pleural Disease: Treatment, Cost and Side Effects

Pulmonary pleura are the thin membranous covering or sac that surrounds each of the two lungs. There are mainly two pleurae- the visceral and the parietal pleura. The visceral pleura is the membrane that lies close to the lungs and the parietal pleura outlines the visceral. The space between the two pleural membranes is called pleural cavity which is filled with pleural fluid. This fluid helps in absorbing any shock to the pleural membrane and prevents any friction between the two membranes while breathing in and out. The volume of the pleural fluid is maintained by a production and removal rate, which if goes faulty in any case results in increase in the volume. This can lead to disease of the pleural fluid or membrane. The most common of the pleural diseases is pleural effusion. The diseases that affect the pleural cavity or the membranes can be pleurisy, pleural effusion, pneumothorax, hemothorax and pleural tumors. Pleurisy occurs because the pleural cavity gets infected, pleural effusion is building up of excess fluid in the pleural cavity, pneumothorax is the result of air caught in the pleural cavity and hemothorax is the presence of blood in the cavity. Signs and symptoms of pleural diseases can be a cough, shortness of breath, fever, unexplained weight loss and sore throat. Treatment for pleural disease includes bullectomy, chemotherapy, minimally invasive tumour removal, pleurodesis, pleurX catheter, radiation therapy, thoracentesis, thoracostomy and tumour ablation.

There are several treatment methods for pleural diseases. Pleurodesis is a therapy wherein the excess fluid in the pleural cavity of lung cancer patients is drained out. The excess fluid build-up increases the pressure in the lungs. Diagnosis is done by an X-ray of the chest along with testing the sample liquid from the pleural cavity. Pleurodesis is done using several methods like thoracoscopy wherein with a help of a small and thin instrument called thoracoscope the fluid is drained out. The thoracoscope is fitted with a lens and light to navigate to the pleural cavity and carry out the process. Thereafter, an antibiotic solution or talc is inserted into the fluid which circulates all throughout the fluid causing a slight irritation in the lungs as the membranes stick to each other. This process reduces the built-up pressure in the lungs and makes breathing easier. Bullectomy is a procedure which involves removal of an air pocket or air bubble which gets created due to any lung disease thereby putting a pressure on the lungs and difficulty in breathing. Minimally invasive tumour removal is a procedure that involves video assisted thoracoscopic surgery to remove tumour in the lungs. Chemotherapy is used to treat lung cancer using certain medications. Radiation therapy is also used to destroy cancer cells using x-rays, electron beams, protons or gamma rays. The excess fluid removal is also done by s few other effective procedures like pleurX catheter method, thoracentesis and thoracostomy.

Anyone is diagnosed with build-up of excess fluid in the lungs or develop an air pocket in the lungs are eligible for the treatment.

Person who does not get the symptoms of pleural diseases and doesn’t even get positive diagnostic test for the disease are not eligible for the treatment.

Side effects after thoracocentesis may include pulmonary edema, bleeding and infection and difficulty in breathing. There may be a pain after carrying out pleurx catheter method. Pleurodesis may have mild symptoms like pain and fever.

The post treatment guidelines after treatment of pleural diseases would depend upon the underlying cause of the disease. Usually smoking is recommended to be avoided after the treatment or even when it is diagnosed.

Recovery from pleural disease treatment may require 2 to 4 weeks.

The price of the treatment may range from Rs. 10,000 to Rs. 20 lakh depending upon the underlying cause of the disease.

Yes, the results are permanent.