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Pleural effusions can be a symptom of cancer.
We hope this information answers your questions. If you have any further questions, you can ask your doctor or nurse at the hospital where you are having your treatment.
The lungs are covered by a membrane, or lining, called the pleura, which has an inner and outer layer. The inner layer covers the lungs. The outer layer lines the rib cage and diaphragm, which is a sheet of muscle that separates the chest from the abdomen.
The pleura produces a fluid that acts as a lubricant that helps you to breathe easily, allowing the lungs to move in and out smoothly. Sometimes too much of this fluid can build up between the two layers of the pleura; this is called a pleural effusion.
A pleural effusion
View a large copy of the pleural effusion diagram|
Pleural effusions are quite common and are often due to infections such as pneumonia or heart failure, which is when the heart is not pumping the blood efficiently around the body. A pleural effusion can also be a symptom of several types of cancer. The effusion can develop if cancer cells have spread into the pleura, where they can lead to irritation and cause fluid to build up. The types of cancer that are more likely to cause a pleural effusion are:
The build-up of fluid presses on the lung, making it difficult for the lung to expand fully. In some situations, part or all of the lung will collapse. This can make you increasingly breathless|, not only when you’re active, but also when you’re resting. You may also get some chest pain and a cough.
A chest x-ray and/or an ultrasound scan may be used to diagnose a pleural effusion. Sometimes other tests may be needed to confirm the diagnosis and the cause of the effusion.
If the lung re-inflates after the fluid has been drained, it may be possible to seal the two layers of the pleura together to prevent the fluid from building up again. This is known as pleurodesis. It is usually done using a sterile talc that is injected through the drain.
The doctor injects the drug through the drain and then leaves the drain clamped for about an hour. You will be asked to lie in various positions in the bed (on your back, your front, and your left and right sides) to help the drug circulate around the lining of the lungs. The drain may then be attached to a suction machine to apply a small amount of pressure, which encourages the pleura to seal together. After a pleurodesis, the drain will usually remain in place for 24 hours.
If there is a stitch that has been holding the drain in, it can be pulled together when the drain is removed, sealing the hole that is then covered with a dressing. The stitch is usually removed about a week later. Sometimes just a dressing is used to cover the area where the drain has been. After a pleurodesis, you may get chest pain for a day or so and you may need to take painkillers.
If you’re advised to have a pleurodesis, your doctor or nurse will give you more information about it.
It may be possible to drain a pleural effusion and to do a pleurodesis using a procedure called medical thoracoscopy. A flexible tube (thorascope) is put into your chest through a small cut made in your chest wall. The tube has a light and a camera at the end so that the doctor can see the area clearly.
You will be asked to lie on your side and given an injection of a sedative to make you feel drowsy. A local anaesthetic will be given to numb the area where the doctor will make one or two small cuts. The thorascope is then put into the chest. Any fluid can be drained, and the doctor can spray sterile talc through the thoracoscopy tube to help the layers of the pleura stick together. The procedure takes about 40-60 minutes.
Content last reviewed: 1 January 2013
Next planned review: 2015
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© Macmillan Cancer Support 2013
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