Many of the procedures that are performed on a daily basis by IR have a role in the care of patients in the late stages of cancer. Whether it is the management of fluid that is needed in a patient with ascites or pleural effusions or the need for nutritional supplementation via a feeding tube (such as a gastrostomy or gastrojejunostomy tube), IR can perform these and other procedures to improve the quality of life of patients with advanced cancer.
paracentesis
Ascites is defined as the accumulation of fluid in the abdomen. Some patients with cancer can develop ascites due to the cancer obstructing the lymphatic system, the drainage pathway of your abdominal and pelvic cavity. Generally speaking, this type of ascites does not respond to medical management and diet modification. This can lead to abdominal discomfort and changes in appetite. Patients often turn to paracentesis procedures for relief. These procedures are performed to remove fluid from the abdomen. We perform paracentesis procedures using ultrasound for guidance. In other words, we perform an ultrasound examination of the abdomen and then mark the skin in the location of the largest amount of fluid. Once the skin is marked, we numb that area with local anesthesia and then place a small needle into the abdomen. Fluid is then able to be removed from the abdomen through that needle. This procedure is successful at easing the symptoms associated with ascites but may often need to be repeated in patients with cancer. As a result, some patients may prefer having a catheter placed into the abdomen so that they can perform home-based drainage of the fluid. This procedure is performed by Albany IR as well.
thoracentesis
Patients with cancers involving the chest may develop pleural effusions. This means that fluid accumulates in between the lining of the lung (the pleura) and the lung itself. The fluid can restrict the lung from fully inflating and deflating during breathing, which can lead to shortness of breath. At times, the fluid can even compress the lung. When patients develop shortness of breath and an x-ray or CT scan shows that pleural fluid is present, they may turn to a thoracentesis procedure to remove the fluid from the pleural space. We perform thoracentesis procedures using ultrasound for guidance. In other words, we perform an ultrasound examination of the chest and then mark the skin in the location of the largest amount of fluid. We usually mark a small area of the back in between the ribs. Once the skin is marked, we numb that area with local anesthesia and then place a small needle into the chest. Fluid is then able to be removed from the chest through that needle. Thoracentesis procedures are successfully at removing pleural fluid and helping to ease shortness of breath. However, fluid may return in patients with cancer. As a result, some patients will have Albany IR place a catheter, such as the Pleurx catheter (Becton, Dickinson and Company), into the pleural space which will enable them to perform home-based drainage of this fluid.