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Recurring Fluid Build Up


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Hi All,

My mother in law was very recently diagnosed (1-7-06) with stage 3b NSCLC. We are just beginning to grasp what the road ahead may be like for her, for all of us. Besides the cancer she is a very healthy woman who has never smoked a day in her life. In fact she was climbing Half Dome in Yosemite when she noticed for the first time that she felt more out of breath than usual for this hike. Passing this off as age and fatigue it was her hiking group that urged her to go to the doctor when a low level cough prevented her from walking at any incline whatsoever. She was diagnosed with stage 3B LC on account of a malignant pleural effusion (2 Qt) in her left lung, which, I am told is a fluid build up around her lung. After one bout of chemotherapy, (I don’t know the exact drugs) a PET scan revealed that the fluid has returned (1 1/4 Qt). I know each individual LC is different; however I was wondering if anyone has any similar personal stories they would share? What does the recurring fluid build up mean? Is this to be expected?

Thank you

K.

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Hi All,

My mother in law was very recently diagnosed (1-7-06) with stage 3b NSCLC. We are just beginning to grasp what the road ahead may be like for her, for all of us. Besides the cancer she is a very healthy woman who has never smoked a day in her life. In fact she was climbing Half Dome in Yosemite when she noticed for the first time that she felt more out of breath than usual for this hike. Passing this off as age and fatigue it was her hiking group that urged her to go to the doctor when a low level cough prevented her from walking at any incline whatsoever. She was diagnosed with stage 3B LC on account of a malignant pleural effusion (2 Qt) in her left lung, which, I am told is a fluid build up around her lung. After one bout of chemotherapy, (I don’t know the exact drugs) a PET scan revealed that the fluid has returned (1 1/4 Qt). I know each individual LC is different; however I was wondering if anyone has any similar personal stories they would share? What does the recurring fluid build up mean? Is this to be expected?

Thank you

K.

K :

The fluid is most likely returning because the cause is the malignancy. That is, caused by the cancer vs. some other non-cancerous and successfully treated cause such as pneumonia. The one bout of chemo tx is either ineffective and / or it's simply too soon for the chemo to exert a therapeutic response against this particular process. Treatments to block or seal off this process are available but I will defer to those board members that have actually had one of these procedures performed. My wife had a 2 qt. malignant pleural effusion but it didn't return, presumably resolved at the cellular level as part of her dramatic response and improvement with Tarceva.

Good luck.

B

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I have read that sometimes chemical pleurodesis is used for malignant pleural effusions.

Also since she is a non-smoking women you might want to look into Tarceva and there are a bunch of other EGFR inhibitors. It is supposed to work best in non-smokers especially women

There are also newer drugs called irreversibal EGFR inhibitors like HKI-272

"irreversible anilinoquinazoline EGFR inhibitor"

Note: None of these drugs are FDA approved, though I think Tarceva is? Is this correct anyone?

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My mom had chemical pleurodesis done for pleural effusion. One thing you should be aware of is that your mom may not be eligible for some clinical trials if she has had this procedure. Of course if you decide not participate in any chemical trials, then you don't have to worry about it.

My mom's procedure was very successful; she had to have fluid drained twice in two weeks and after the procedure she never got it again.

Good luck to you.

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Jim had fluid withdrawn (2 liters)last summer by thoracentesis. There has been some recurrence but not severe. If that occurred, they encouraged us to consider the pleurodesis (talc treatment) where they basically put powder into the space between the pleura and lung, creating scar tissue which closes the space and prevents fluid from accumulating again. Jim had a hard time with the thoracentesis (passed out during procedure) and hopes it won't have to be done again! When the fluid accumulates it can cause severe shortness of breath as well as pain. Good luck!

Sandy

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I don't have substantive help for you. I just know how hard the complications can be, sometimes. my mom had pneumonia and a pericardial effusion that turned out to be a bleed, versus malignant fluid. sorry I can't help more. keep us posted, and know that you're in my thoughts and prayers.

xoxo

amie

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