Effectiveness of Doxycycline for Treating Pleural Effusions Related to Cancer in an Outpatient Population
Status:
Recruiting
Trial end date:
2021-12-31
Target enrollment:
Participant gender:
Summary
Patients with cancer may experience problems with their breathing due to a fluid accumulation
around their lungs called malignant pleural effusion (MPE). This fluid can be drained but
draining may not stop the fluid from accumulating again. MPE can cause shortness of breath
during activity and at rest leaving patients feeling as though they cannot catch their breath
enough to be comfortable. Other symptoms can include pain, cough and weight loss.
One way to stop the fluid from accumulating is to create scar tissue between the lung and
chest wall so there is no more room for fluid accumulation. This procedure is called
pleurodesis. Pleurodesis is the standard of care at most centres across Canada. This
procedure is done by injecting a drug into the space between the lung and chest wall through
a catheter, Doxycycline is one of the drugs currently used for this purpose. Traditionally,
patients are admitted for pleurodesis, mostly because the size of the catheter used to inject
the medication is very large but also because of the potential complications that can happen
with these larger chest tubes.
At our centre, most patients with MPE are managed at home with a smaller sized catheter known
as a Pleurx catheter. The Pleurx catheter allows patients to remain at home for treatment and
trained staff come into the home to both drain the MPE and monitor the patient. Sometimes,
patients experience pleurodesis through use of the Pleurx catheter alone.
Pleurodesis with doxycycline can happen faster than with the Pleurx catheter alone. It has
been our experience with a limited number of patients that it is safe to perform pleurodesis
using the Pleurx catheter for doxycycline injection in an outpatient setting.