Pleural Effusions

LuBelle · New User Joined: 30 Jun 2007 Posts: 3 Location: Louisiana

Hello, Everyone. I just found this forum and feel that I will be a frequent visitor.
My dad was just diagnosed last Tuesday with cancer cells in pleural fluid. They drained 2 liters of fluid from his left lung. It has already begun to reaccumulate. He had a CAT scan yesterday to try to find if in fact, the cancer is in the lung or elsewhere. They told him that since the fluid had already started to accumulate, he was probably in stage IV and that there was probably nothing they could do as far as cure.
He will see a surgeon on Monday to discuss a procedure to help the pleural fluid problem. Is anyone familar with the procedure where they inject talc between the pleural spaces to seal it I would like to read about disadvantages or problems anyone has experienced with this. I was thinking that maybe Dad should simply opt for the permanent drainage catheter. Any advice is welcome. Thanks.

Vee Smith · Moderator Joined: 12 Feb 2006 Posts: 796 Location: UK

Hello, LuBelle, I am sorry your father is having this problem. I have had lung drains and a pleurodysis (for secondary pleural effusion).

I had no basic problems with the process, though it would have helped to have been given more advice on how to expand the lung afterwards. It was done under local anaesthetic, and I had to stay in for 24 hours to ensure it had worked. I was warned that if it failed, I would need a catheter, but it has been fine, and after the access point healed I've had no trouble. You do have to be careful for a few weeks not to overstrain the lung, but that's all.

LuBelle · New User Joined: 30 Jun 2007 Posts: 3 Location: Louisiana

Thank you so much for your prompt reply. Did you have a lot of pain both during the procedure and afterwards?
I have read that we all have fluid in our pleural spaces and that it the lung from rubbing as we breathe. Being that Dad is in late stage, I hate to give him more pain than necessary, although, I would imagine a permanent catheter wouldn't be pleasant either. Right now, he actually feels pretty decent other than problems with sleep.
I still welcome from anyone, any more comments on the topic. I'm desperate for answers.

LuBelle · New User Joined: 30 Jun 2007 Posts: 3 Location: Louisiana

Also, another question I forgot to ask. Does the pleuradesis completely stop the buildup of fluid regardless of where it is coming from? I wonder where the fluid would go if it is not accumlated in the pleural spaces. Would it go into other tissues of the body causing swelling?

pbj11 · Site Admin Joined: 12 May 2007 Posts: 1301

Welcome LuBelle,

Sorry to hear that your Dad is going through this. My husband had horrible pleural effusion issues for many months but refused to do the pleurodesis procedure. He has limited breathing as it is, so he was afraid of what sealing the lung to the wall would limit it more. Fortunately the effusion has stopped and never contained cancer cells. I think you can have pulmonary rehabilitation for a number of breathing related issues. I've tried to get my husband to go, but he's a poop and doesn't want to.

The sealing completely takes away the little space you have to fully expand the lungs. Sometimes there is no other alternative. We were told my husband would have to spend 4-10 days in the hospital with a tube in his side again. He needed both lungs done and when he heard "tube" he said forget it! (He didn't like the tube after his wedge-section biopsy.) He was lucky that the effusions finally went away. He is also Stage IV.

Here is a link for a very good description written by an oncologist who specializes in lung cancer. http://onctalk.com/?p=388

Best wishes
PBJ

Vee Smith · Moderator Joined: 12 Feb 2006 Posts: 796 Location: UK

My pleural effusion made it very difficult to breathe properly as the lung was squashed up within the cavity. What the doctors hoped was that by draining the fluid off over several days, the lung would expand naturally and re-fill the cavity. Unfortunately this did not happen and the pleurodysis was carried out to ensure the cavity did not refill with fluid.

I was told that normally fluid in the lung cavities absorbs into the tissues and a balance is maintained. Certainly, abnormal fluid levels have not happened again, though a careful watch is kept on my lungs and I have a reduced capacity.

Pain is a subjective thing. I had relatively little pain, and that was highly localized. The lung ached, rather than hurt, but the feeling went away after about a week. Very occasionally and briefly I get a sort of stitch where the drain had been, but that is not unusual for any form of invasive surgery.

My information is that if deep-breathing exercises are carried out, then the lung is capable of re-expanding.

I have to emphasize, this was a secondary for another cancer, and the lung itself was not affected.

pbj11 · Site Admin Joined: 12 May 2007 Posts: 1301

Oh gosh yes, pleural effusion makes it very difficult to breathe. My husband had fourteen thoracentesis done to drain the fluid every time they refilled. He never had complications with that procedure and our lung specialist was very conservative about pushing for pleurodesis. Believe me, it was brought up on many occasions by both the oncologist and lung specialist. His effusion was more due to lung irritation from one of the chemo drugs and radiation combined and it took nine months to settle down.

He just was very stubborn about not wanting a permanent fix. Like I said before, his fluid was tested frequently and never had cancer cells in it. He was very lucky to have the fluid go away on its own. Most people do have to have a pleurodesis procedure done.

PBJ

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