Fluid around the heart

[BeckyCW]

I am wondering what causes a cancer patient to have fluid around the lungs, and how serious this is? (My brother will have surgery tomorrow morning to remove fluid... Is this a pericardial window?)

Also, my uncle just called and was wondering why they must cut and insert a tube to drain the pericardial sac, instead of using a needle, like they did to drain fluid from his (my uncle's) collapsed lung a few years back after he had heart surgery. We figure there's a good reason, we're just curious, since the needle would seem less invasive.

Thank you!

BeckyCW

[kimblanchard]

The lung in normal conditions is coated by a thin layer of fluid that allows it to slide in the chest with respirations. This fluid is secreted by the pleura, a layer of cells that lines both the lungs and the chest wall. Cancer can spread onto this pleural lining. In normal conditions, this fluid is always in a state of balance as it is drained back into the bloodstream by the lymphatic system at the same rate that it is made. When cancer gets on the pleura, it can become irritated causing it to overproduce fluid and the microscopic channels that drain the fluid can become clogged up so the fluid can't get out. This is what causes a pleural effusion, the build up of fluid around the lung. Sometimes if the fluid is analyzed you will see cancer cells in it and sometimes you won't because the problem is really due to the involvement of the pleura, the fluid is basically just a reaction.

The same thing applies to the heart which is encased in a similar fluid producing sac called the pericardium. Developing fluid around the heart is a bigger problem because as the pressure builds, it can actually make it hard for blood to get into the heart. While the fluid can be drained with a needle, that is only a temporary procedure since it fixes only the symptom, not the problem. To eliminate the fluid from reaccumulating, a pericardial window procedure is usually performed where the sac is opened up allowing the fluid to escape.

Similarly, pleural effusions around the lung also tend to reaccumulate after being drained. To prevent this, a pleurodesis procedure may be done where talcum powder is inserted into the pleural space after the fluid is drained. This is very irritating and will cause scarring to seal off the space where the fluid is forming to prevent it from reaccumulating.

Ultimately, however, the cancer is the problem in both scenarios and treatment of the cancer if possible is most important.

[BeckyCW]

Dr. Joe, thank you so much! Katie wrote to let me know I had misspoken when I asked the question... I meant what causes fluid around the heart (which my brother had surgery for this morning), rather than fluid around the lung. Thank you for adding the info about the heart. I just heard from Karen, and David came through the surgery this morning just fine. Thanks again,

BeckyCW

[Justakid]

Becky-

Just heard about Dave. I haven't read anything on the board, only complained.

I had no idea that he was going through this, Karen called and he is in recovery waiting for a bed. Just to let you know.......his surgeon is wonderful. Dr. B did my lung surgery and biopsy. All the Nurses are scared of him so Dave will get great treatment! I'm going to go cheer him up once he is out of ICU and friends can visit!

He's in good hands! Dr. B will take care of him!