Correspondence to: Carolyn M. Dresler, MD, FCCP, PO Box 177, Mount Tabor, NJ 07878; e-mail: email@example.com
To the Editor:
The recent article by Werebe and colleagues (January
1999)1 concerning the systemic distribution of talc was a
fascinating and timely study. This group has a very large experience
with talc pleurodesis, and they are to be commended in pursuing not
only the efficacy of the procedure, but also the safety. As they are
aware, a large (n = 500) multicenter trial is underway in the United
States exploring the efficacy of talc pleurodesis—administered either
through a chest tube as a slurry or via video-assisted thoracoscopy as
an insufflated mist—in patients with a malignant pleural effusion. As
co-principal investigator of this trial, I have been very sensitive to
the potential safety issues relative to talc insufflation. For this
reason, I believe we need further studies exploring the results of
Somewhat surprisingly, all talcs are not equal. The crystal structure
and size of the talc particle may vary depending on the location of the
talc mine! Perhaps, it is this variability in the size or the structure
of the talc that determines the permeability or distribution, and thus
potential toxicity of intrapleural talc.
Approximately 250,000 people each year in the United States have a
malignant pleural effusion. Talc is the most effective sclerosing agent
identified to date. Thus, it is important to confirm its safety. I was
very pleased to read this study by Werebe and colleagues and hope that
further discussion and research is engendered.
Become a CHEST member and receive a FREE subscription as a benefit of membership.
Individuals can purchase this article on ScienceDirect.
Individuals can purchase a subscription to the journal.
Individuals can purchase a subscription to the journal or buy individual articles.
Learn more about membership or Purchase a Full Subscription.
Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.
Some tools below are only available to our subscribers or users with an online account.
Download citation file:
Web of Science® Times Cited: 8
Customize your page view by dragging & repositioning the boxes below.
Enter your username and email address. We'll send you a reminder to the email address on record.
Athens and Shibboleth are access management services that provide single sign-on to protected resources. They replace the multiple user names and passwords necessary to access subscription-based content with a single user name and password that can be entered once per session. It operates independently of a user's location or IP address. If your institution uses Athens or Shibboleth authentication, please contact your site administrator to receive your user name and password.