Pleural Effusion

Quick Summary

Pleural effusions are one of the riskiest and most painful symptoms that develop in pleural mesothelioma patients. Effusions are a buildup of fluid within the lung lining (the pleura) as the result of inflammation caused by a cancerous tumor. It’s important for patients to receive treatment for pleural effusions to avoid complications such as a collapsed lung.

What Are Pleural Effusions?

Pleural effusions are a symptom commonly associated with lung cancers.

Over 1.5 million people are diagnosed with a pleural effusion each year in the United States. Pleural effusions are a common symptom that develops in over 90% of pleural mesothelioma patients.

They’re one of the primary contributors to pleural mesothelioma symptoms like shortness of breath and tightness in the chest. As fluid builds up in between the pleural linings, it restricts lung movement, which seriously disables the affected person.

Pleural effusions, or “water on the lungs”, can be treated with palliative surgeries that drain fluid from the chest. Draining excess fluid buildup relieves chest pressure, allowing the patient to breathe more easily.

Research has shown that virtually every patient with pleural effusions who underwent fluid drainage experienced a decrease in effusion symptoms.

What Are the Causes of Pleural Effusions?

Pleural effusions are caused by an excess buildup of fluid in the protective lining that covers the lungs and chest (the pleura).

In a healthy person, there is always a small amount of fluid in the pleura which allows for lubrication and movement. The normal amount of pleural fluid allows you to breathe comfortably. The body is good at regulating this fluid and will evacuate excess fluid on its own.

In patients who develop pleural mesothelioma, tumors accumulate in the pleura, which causes inflammation and constriction of the lining. Added pressure due to inflammation causes pleural blood vessels to leak fluid, which leads to an excess of liquid in the pleura.

Pleural effusions are common in pleural mesothelioma patients. However, other asbestos-related illnesses can cause pleural effusions as well. Lung cancers and asbestosis caused by asbestos exposure can also create pleural effusions. If you’re experiencing pleural effusions symptoms, then it’s important to know the underlying cause so that you can receive proper treatment.

What Are the Symptoms of Pleural Effusions?

Pleural effusions on their own are considered a sign of pleural mesothelioma, and they are responsible for many pleural mesothelioma symptoms.

Specialists consider pleural effusions to be a strong early indicator of mesothelioma.

That’s why reporting pleural effusion symptoms, along with your history of asbestos exposure, could lead to a life-saving early diagnosis of pleural mesothelioma.

If you suspect you may have a pleural effusion, watch for the following signs and symptoms:

  • Dry cough
  • Quickened breathing
  • Shortness of breath
  • Chest pain
  • Sharp pain when coughing or taking deep breaths
  • Not being able to breathe properly when lying down
  • General feeling of being unwell (malaise)
  • Fever
  • Fatigue

As pleural effusions worsen, the shortness of breath may cause panic in the affected person. Some people report feeling as though they are being suffocated because the constriction has become so intense. Other people report feeling like they are drowning as the fluid accumulates.

Other complications from pleural effusions can include infection. Empyema—when pleural fluid becomes infected—can be fatal in particularly unhealthy patients. If mesothelioma has made its way into the lymphatic system, it will have compromised the immune system, making it difficult to combat infection. Untreated pleural effusions can also cause the lung to collapse.

Some patients may have pleural effusions and never display any symptoms, making it a difficult condition to detect. Sometimes with pleural mesothelioma patients, the symptoms of pleural effusions go unfelt for so long that the cancer isn’t diagnosed until it’s in advanced stages.

Testing for Pleural Effusions

If you report symptoms such as difficulty breathing and chest pain to your doctor, he or she will order a chest x-ray.

Chest x-rays can show doctors whether there is a concerning level of fluid buildup in the chest. However, fluid buildup can indicate other conditions like pneumonia or congestive heart failure. It’s vital to report any known history of asbestos exposure to your doctor.

Mesothelioma Diagnosis Update

If x-rays confirm there is excess fluid, the next step is to take a sample of the fluid for testing. Doctors use a procedure called a thoracentesis, whereby they insert a needle or thin tube into space where the fluid has accumulated. They then withdraw a sample of the fluid and send it to a medical lab for testing to determine if you have mesothelioma.

Lab technicians analyze the sample fluid to determine if the effusion has been caused by cancer. Lab technicians know if the effusion is caused by cancer by the level of protein the fluid contains. Protein-rich pleural fluid is a strong indicator of cancer. In these cases, further diagnostic steps must be taken to determine if the cause is mesothelioma or another type of cancer such as lung, breast or lymphoma.

Pleural Effusion Treatments

Treating pleural effusions is an important part of the overall treatment plan that specialists will recommend.

While it’s not a treatment to stop or control the mesothelioma itself, it’s a symptom-management effort to help make the patient comfortable and improve their quality of life. In other words, treating pleural effusions is part of palliative care.

Mesothelioma Treatment Update

When doctors treat pleural effusions, they use the thoracentesis technique to drain out the excess fluid. The needle is inserted directly into the chest, the fluid is collected and drained into a bag. Thoracentesis is a simple and quick procedure done through local anesthetic. However, patients will often experience a continued recurrence of pleural effusions.

Rather than having to keep undergoing fluid drainage, doctors may recommend a pleurodesis. During a pleurodesis, doctors administer certain types of drugs into the pleura to cause it to become inflamed.

These drugs are also known as sclerosing agents, and they include substances like talc, tetracycline or doxycycline. These agents deliberately cause scarring and inflammation in the pleural tissues (pleura sclerosis), which effectively closes up the pleura and prevents fluid accumulation. However, this is only a short-term solution, and doctors only perform it in certain cases when the patient is healthy enough.

Getting Personalized Treatment for Pleural Mesothelioma

Ultimately, doctors always remain focused on treating the underlying condition of pleural effusions, which is pleural mesothelioma. If they can effectively treat mesothelioma using a combination of surgery, chemotherapy, and radiation, then they can also manage symptoms like pleural effusions.

If you suspect you may have pleural mesothelioma due to signs of effusions, then contact a mesothelioma specialist today.

Because mesothelioma is so rare, general practitioners do not have the experience that’s required to accurately diagnose and treat mesothelioma. Specialists are surgical oncologists dedicated to researching and treating malignant mesothelioma and can provide life-extending treatments to patients.

For more information on working with a mesothelioma specialist, contact our Patient Advocates now.

View Author and Sources
Author

Sources
  1. Kamran Boka, MD, MS, “Pleural Effusions” Retrieved from Medscape. Accessed on December 14, 2017.
  2. Winston W Tan, MD, FACP, “Mesothelioma: Practice Essentials” Retrieved from Medscape. Accessed on December 14, 2017.
  3. Cleveland Clinic, “Pleural Effusion Causes, Signs & Treatment” Retrieved from: https://my.clevelandclinic.org/health/diseases/17373-pleural-effusion-causes-signs--treatment. Accessed on December 14, 2017.

Last modified: May 7, 2018