Malignant pleural effusions complicate cancer but can be treated

September 07, 2016
Malignant pleural effusions are unfortunately a common problem in many advanced cancers. This condition can be debilitating at a time when individuals with cancer are fighting the disease on several fronts. But a pleural disease specialist can help patients manage a malignant pleural effusion, and many times tailor treatment specifically to their individual situation and needs.

A malignant pleural effusion is defined by the presence of cancer cells in the buildup of excess pleural fluid (fluid that surrounds the lungs) or on the pleura (the lining of the lung and chest wall). It can occur with almost any cancer type, and for the vast majority of individuals it can be debilitating.

A hallmark of the condition is that it can occur repeatedly, causing shortness of breath, coughing, fatigue, and/or chest pressure. Imaging tests can easily spot fluid in the pleural space, and simple drainage procedures can often help clinicians advise about further treatment, if needed.

Diagnosing a malignant pleural effusion

To diagnose a malignant pleural effusion, a pathologist studies a pleural fluid sample to look for cancer cells. Sometimes this type of diagnosis isn’t definitive and a pleural tissue biopsy may need to be done.

Unfortunately, a diagnosis of malignant pleural effusion often is a sign of metastatic cancer, which occurs when a cancer spreads from its original source to other parts of the body. But this doesn’t mean all hope is lost. There are now a number of options for managing advanced cancer and pleural disease.

Managing a malignant pleural effusion

The goal of managing a malignant pleural effusion is palliative, easing discomfort and improving breathing. Many individuals are treated for the condition at the same time they are undergoing chemotherapy and/or radiation.

There are a number of options for managing a malignant pleural effusion. The most common are:

• Medical management: Opiates and oxygen are used to relieve discomfort.
• Thoracentesis: A needle or plastic tube is used to remove fluid in the pleural space.
• Indwelling tunneled pleural catheter: A catheter is placed in the chest to drain fluid.
• Chemical pleurodesis: Chemicals are used to close off the space where fluid accumulates.

What to do next

Each treatment option has pros and cons, so discuss these with a pleural disease expert before making a decision. Many options not only improve quality of life, they also can be customized to an individual’s medical and life situation.

If you have further questions about malignant pleural effusion or want to learn more about Swedish’s Thoracic Surgery and Interventional Pulmonology Services, call our office at 206-215-6800 to make an appointment.
Topics: Cancer