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Wednesday, April 16, 2014
Hardening of fluid in the lungs
My mother is 77 years old. She was diagnosed with breast cancer six years ago and went through chemo, radiation, and surgery (with no masectomy). Today her cancer has resurfaced and the doctors say that she has tumors in her lungs. She had build up of fluid in her left lung with the collapse of that one lung. We think that she had lived with this condition since November 2007 before she was finally x-rayed in July 2008. Her doctors inserted a catherter and then a tube into her lungs to drain it. Once out of the hospital, a tube was left in her so that she could be drained of this fluid every 4-5 days. This situation changed when she developed a staph infection and the tube had to be removed in October 2008. Her doctors say that she is too weak for any operation. They tried to drain her last week, but hardly any fluid came out. The doctors think that the fluid is hardening in her lung. She has a hard time breathing, especially at night. We will be placing her on oxygen today. Is there any way for the fuild to be broken up so that it could be drained? Is there any type of enzyme that could be given to my mom so that the fuild will remain in a liquid state? Is this a common situation in elderly people and what usually helps? Thank you
Thank you for your question. Fluid around the lung termed "pleural effusion" can occur in many settings including infection, heart failure and malignancy. In the cases of infection or malignancy, it is important to drain the fluid to prevent the fluid from becoming "complicated" or "hardening" as you term it. Once pleural fluid has reached this stage, it can be very difficult to manage without a surgical intervention. This is not necessarily common to the elderly but rather occurs in situations where the fluid has remained undrained for some time and as a result has thickened. Occasionally, a combination of a chest drain and lysing agent (used to break up the fluid) can be effective but the results from studies are mixed. If surgery is not an option for your mother, then you should discuss this option with your provider.
Patrick Nana-Sinkam, MD
Associate Professor of Pulmonary, Allergy, Critical Care & Sleep
College of Medicine
The Ohio State University