y abrasions. When the lung tissue heals, it becomes permanently adhered to the chest wall without impairing the patients breathing. The effects of the procedure, called medical thoracoscopy with talc pleurodesis, are immediate and last a lifetime.
Shortness of breath is a horrible way to die, Antony said. The procedure spares the patient and the family the misery of watching their loved one suffer. Its been used very extensively in Europe but its had slower acceptance (in the United States), perhaps because of the need to learn a new technology.
The Food and Drug Administration approved talc for use in medical thoracoscopy in 2003, but UF is one of just a handful of U.S. institutions that perform the outpatient procedure on a routine basis. Doctors have noticed that patients who undergo medical thoracoscopy with talcum powder live up to 18 months longer than expected. To figure out why, Antony compared lung fluid from 16 patients with malignant pleural effusions before and after doctors dusted their lungs with talc. The results were startling.
We were surprised to find that talc has added benefits besides causing scarring and taking away the fluid that surrounds the lung, Antony said. The cells that cover the lining of the lung are stimulated by the presence of talc to produce a factor that inhibits the growth of blood vessels and kills the tumor cells themselves.
Less than one day after treatment with talc, patients began producing 10-fold higher levels of endostatin, a hormone released by healthy lung cells. Endostatin prevents new blood vessels from forming, slows cell growth and movement, and even induces nearby tumor cells to commit suicide. All of these make it hard for tumors to grow and spread into healthy lung tissue.
When endostatin was first discovered in 1997, doctors hoped its tumor-fighting properties would lead to a cure for cancer. But clinical trials have been disappointing, possibly because
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