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Therapeutic thoracentesis symptoms and activity: a qualitative study
  1. Chloe Twose1,
  2. Rebecca Ferris1,
  3. Andrew Wilson2,
  4. Najib Rahman3,
  5. Morag Farquhar4 and
  6. Eleanor Mishra1
  1. 1Respiratory Medicine, Norfolk and Norwich University Hospitals NHS Foundation Trust, Colney Lane, Norwich, UK
  2. 2School of Medicine, University of East Anglia, Norwich, UK
  3. 3Nuffield Department of Medicine, University of Oxford, Oxford, Oxfordshire, UK
  4. 4School of Health Sciences, University of East Anglia, Norwich, UK
  1. Correspondence to Dr Eleanor Mishra, Norfolk and Norwich University Hospitals NHS Foundation Trust, Colney Lane, Norwich, UK; eleanor.mishra{at}


Introduction Malignant pleural effusions (MPEs) commonly occur in patients with advanced cancer. Drainage of fluid is used to relieve symptoms and improve quality of life.

Objective To improve our understanding of how therapeutic aspiration affects symptoms and activities in patients with MPE.

Methods Patients presenting to the Pleural Clinic at Norfolk and Norwich University Hospital with a confirmed or suspected MPE participated in up to three semistructured interviews during their diagnostic/therapeutic pathway. Interviews were analysed using framework analysis by two researchers independently.

Results Sixteen patients participated. Symptoms reported before drainage included breathlessness, cough, chest pain, fatigue and anorexia. Symptoms affected their activities, including walking, bending over and socialisation. Patients described anxiety about the underlying diagnosis and fear of over-reliance on others. Expectations of drainage outcome varied, with some hoping for a cure and others hoping for any improvement. After drainage, breathlessness, chest pain and cough improved in some patients. They reported feeling and sleeping better, but fatigue and poor appetite remained. Participants were more active after aspiration, but the duration of improvement was a few days only. Despite this, patients still felt the procedure worthwhile.

Conclusion Overall health and respiratory symptoms improved following drainage, but constitutional symptoms did not improve. This may be because constitutional symptoms are caused by the underlying cancer. This study suggests that clinicians should consider a range of symptoms, rather than just breathlessness, in planning outcomes for clinical trials. These results are important to inform patients about the potential benefits and duration of symptom improvement after therapeutic aspiration.

  • cancer
  • lung
  • other cancer
  • hospital care
  • quality of life
  • respiratory conditions

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  • Contributors AW, NR, MF and EM conceived of and designed the study. CT and RF conducted, transcribed and analysed the interviews. All authors contributed to the paper. EM is responsible for the overall content of the paper and acts as guarantor.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval This study was approved by North West-Greater Manchester West Research Ethics Committee (REC reference: 18/NW/0774, IRAS ID: 248840) and undertaken in accordance with good clinical practice guidelines.

  • Data availability statement Data are available upon reasonable request. Interview transcriptions are available from corresponding author.

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