Out Patient Talc Slurry Via Indwelling Pleural Catheter for Malignant Pleural Effusion Vs Usual Inpatient Management

Inclusion Criteria: 1. Diagnosis of malignant pleural effusion 2. WHO performance status 2 or less unless performance status is impaired by presence of effusion and likely to significantly improve with drainage 3. Expected survival greater than 3 months Exclusion Criteria: 1. Age less than 18 years old 2. Pregnant or lactating 3. Known allergy to Talc or Lignocaine 4. Lack of symptomatic relief from effusion drainage 5. At least twice weekly drainage cannot be undertaken 6. Lymphoma or small cell carcinoma except\*: 1. Failure of chemotherapy 2. Deemed for palliative management 7. Non malignant effusions 8. Loculated pleural effusion 9. Unable to provide written informed consent to trial participation