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Tuesday, March 11, 2014
Malignant pleural effusions
My brother was diagnosed with small cell lung cancer and recently developed a malignant pleural effusion. What is that, and how is that treated?
Malignant pleural effusion is a collection of fluid in the pleural space (outside the lung, inside the ribs) resulting from spread of the cancer to the pleural surface. With accumulation of fluid, the lung gradually collapses. This causes shortness of breath. The treatment for malignant pleural effusion is to prevent re-accumulation. This does not cure the cancer. However, it improves quality of life by relieving the symptoms of shortness of breath. Re-accumulation is typically prevented by a procedure that causes the pleural surfaces (lining the lung and inside of the ribs) to scar together, thereby obliterating the space and preventing fluid from accumulating. Scarring can be achieved by a number of techniques including: instillation of talc via a chest tube, pleural abrasion and/or talc instillation in the operating room (VATS: video-assisted thoracoscopic surgery), or placement of a longer-term drainage catheter (Pleurx catheter).
Michael F Reed, MD
Assistant Professor of Surgery
College of Medicine
University of Cincinnati