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utahLisa

new to forum-pleaural effusion question

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Hi,

Hoping to gather any information as possible. My mom was diagnosed with pleaural effusion. She is awaiting her appt. for drainage of 1 liter of fluid. Just wondering if anyone can provide any information on how the thorantesis procedure goes and if there are any concerns to be aware of and if it tests positive for cancer, what the next step is. I guess we have to wait diagnosis but it helps to be informed if possible.

I am so sorry for all that some of you have had to endure. Thanks so much, Lisa

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Welcome Lisa!

I cannot answer about the effusion as I never dealt with that issue. But rest assured there will be some of our 'experts' along very soon to share their knowledge. It is the weekend, however, so don't be discouraged if there aren't many responses. Weekends get a bit slow.

Glad that you are aware we are here for you.....if needed.

Kasey

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Lisa,

I had a pleural effusion. They only drained enough to do a biopsy. They did not do a thorantesis procedure to drain all of the fluid. They kind of used it as a marker. My fluid went away with the chemo. Did they say why they want to do the procedure before they do any chemo and see if it goes away by itself? The answer is like they told me it won’t, but then again it did. Have they determined what caused the pleural effusion? Keep us posted.

Stay positive, :lol:

Ernie

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Lisa,

Often they will do a Thoracentisis due to the fact that the fluid can make a person short of breath. Basically, it is not normal to have effusion, so they need to find out why it is happening. They also will send the fluid to have it examined for cancer cells for diagnostic purposes. If a person is already diagnosed with lung cancer, my understanding is that most pleural effusions test positive for cancer cells. But not always. My husband's never had cancer cells and he has had twelve thoracentisis. One liter of fluid = 1000 cc's, which is quite nasty for breathing problems.

The patient sits in a chair, leaning forward. An ultrasound is used to determine the fluid level and then the skin is numbed and a needle is inserted into the back to the pleural area. It is connected to a bag and the fluid is then slowly drained out as low as they can go. Afterwards they do an x-ray to determine if there was any bleeding, collapse, etc. You come out with a band-aid. The procedure is usually very well tolerated and only has a small percentage chance of lung collapse. The Doctor will advise the patient to stop any aspirin regimen prior to doing this procedure to reduce the chance of bleeding.

Oftentimes chemotherapy will actually help slow and sometimes stop pleural effusions. Again, not always. My husband's effusions were a direct result of irritation from prolonged chemo and radiation.

Too often there are no hard and fast rules in the world of lung cancer.

Hope this helps clarify this procedure.

Welthy

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My Gramma had this done and she handled it very well. She immediately could breath better. I believe the risks are very small. Will keep you and your (((Mom))) in my prayers. Hoping it is just pneumonia and your mom feels much better afterward.

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Lisa,

You've gotten a great amount of information here. Welthy provided a lot of practical detail. The "taps", or thoracenteses, are sometimes done just to take out a small amount to sample the fluid and diagnose the problem (a "diagnostic thoracentesis), but in cancer are usually "therapeutic", to relieve shortness of breath and take off as much fluid as possible in the process. The significance in a patient with cancer is that having cancer cells in the fluid unfortunately means that it is advanced lung cancer. If someone has metastatic disease to other parts of the body already, it doesn't change treatment significantly, but if there is no evidence of disease elsewhere, the cancer cells in the fluid mean that the treatment can improve how patients do in terms of living longer and potentially feeling better, but treatment can't realistically cure the cancer.

Welthy already described the possibility of taking fluid out as needed over time. If the fluid continues to develop regularly, and especially if it comes back every few days, many patients undergo a pleurodesis, which is a minor surgical procedure in which a surgeon puts talc or a chemical between the lung and the chest wall to create inflammation and scarring, which keeps the fluid from accumulating there again about two thirds of the time. And tehre's also a catheter, called a Pleurx (pronounced Pleur-EX)catheter, that has holes along it and is implanted in that space between the lung and the chest wall, and the other end goes out through the skin to the side of the chest, where it's clamped off and then unclamped and then attached to a bag to drain off the fluid whenever the patient needs it, even every day or two. Many patients prefer not to have a catheter coming out of their chest, but it's quite subtle and covered with just a bandage, as well as convenient for patients who need it.

That's probably more detail than you wanted.

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Dr. West,

As long as we are on this subject....

I have had several thoracenteses to take off fluid from my right lung. All of the cytos came back WNL. I had a pleruodesis on my right lung (my lc was right-sided)The surgeon said that I had a chylothorax. Is this common with lc?

Also, was wondering why I now have fluid collecting on my left lung? There have been mild to moderate amounts of fluid showing. Is this a chylothorax too do you think? Why would fluid start to appear on my left lung? (there have been varying amounts according to the CT scans this past year, so I suspect no lc cells are to blame.)

And good job Welthy describing the thoracentesis. It hurts hardly at all. It's more creepy than anything. I like to get some fentanyl and versid (versed?) before... it takes most of the creepiness out of it.

Cindi o'h

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Based on the limited information it's possible that the fluid build up is the result of something besides cancer.

My dad who is about to be 95 in Dec. developed pleural effusion a few years ago that had been initiated by uncontrolled dosage of Coumadin. The dosage had not been monitored closely by his doctor and he developed a very fatigue weak condition. Thankfully an office visit diagnosed that the Coumadin dosage was too high and they began to gradually lower the dosage.

The doctor discovered at the same time that he had about a liter of fluid in the pleura. The fluid was not cancerous. He had to have several Thorocentisis to drain fluid accumulations but now is excess fluid free and he never had cancer.

Praying for good results for your mum.

Chanwit.

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I am very thankful for all of your posts. It means a great deal to be able to gather information from those that have had a thorancentisis or are dealing with pleaural effusion. I will update you on the results of my mom's drainage this week.

Again, thank you for taking the time. It truly is the kindness of others that means the most!

Lisa

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Hi, Lisa, and welcome!

By now you probably have your initial questions answered, but I just saw your post and wanted to throw my thoracentecis experience into the mix.

You can see from my profile below how the procedure fit into my overall chronology -- it was one of the first things done after a chest x-ray revealed a large quantity of fluid (or something) around my right lung.

I got the standard surgery prep routine including an IV on the hand, but that was not used until later for a CT scan with contrast dye. For the thoracentecis I sat on a table while the radiologist injected local anesthetic into my side, then was invited to watch the ultrasound monitor while he guided a long needle into the chest cavity and drained about 1 liter of bloody fluid. I could see the needle clearly, but felt nothing. Actually, it was quite interesting. He told me that as the fluid drained and pressure on the lung was relieved, I would feel the need to cough, and he was correct. I immediately felt much better with the fluid removed.

After the CT scan a second procedure was done in a different spot, but that area was apparently too congealed and no more fluid could be drained. Since that time (mid-August) there's been no further need for draining, but if the need ever arose I wouldn't hesitate.

There were no cancer cells detected in my fluid, but that was not necessarily good news in my case, and I was scheduled for a thoracoscopy. Tissue samples taken during the scope procedure were inconclusive, but since the surgeon strongly suspected cancer he proceeded to a thoracotomy (7-inch incision) to get more samples while I was still "under." Those were definitely positive for adenocarcinoma NSCLC, and I was designated Stage IIIB/IV.

Best wishes to you and your mom, and Aloha.

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Lisa, I had fluid drained twice. It was done in a hospital by my pulminary specialist. I sat on the side of the bed with a table in front of me, the nurse put a pillow on the table, and I had to lean on it. I was given a local anesthetic and the fluid was drained. I felt no pain. Just terror that somebody is sticking needles in me - again. An xray was taken about an hour later and I stayed in the hospital for a few hours, they fed me, and later they let me go home.

Dr. West describes procedure very well (and better than I can).

They do tests to see if cancer is present. In my case it was. I had it drained again that year and had a pleurodesis done Nov 2005.

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Dr. West did an excellent job of describing the procedures. I had almost 2 liters drained from my left lung and the fluid did have cancer in it. They did not do any talc procedure or pluera treatment. At this point have not had any more fluid collection in the lung or pleural cavity though. Am very thankful because they thought that might be a recurring problem. Each person seems to react or respond to treatments just slightly different from another person. We are all unique. Praying all your treatments will get rid of every cancer cell. pammmie

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Hi everyone 

i was hoping someone could help us. My mom has been having some intermittent nausea over the past couple weeks and then a couple days ago she developed severe pain in her lower right lung area (like where her bra ends) it radiates from the chest to back and even down the leg once. She had an X-ray a week ago that showed nothing but as the pain got so severe she woke up in a pool of sweat and couldn’t breathe cause the pain was so severe and she is incredibly pain resistant. She was admitted to the hospital, they did another x ray and see some fluid that looks cloudy. First they thought pneumonia but since no fever they don’t think that anymore. She has elevated WBC low CPK and her ekg was normal. Ct scan revealed some fluid in her right lung but they keep saying they don’t want to drain cause it’s not that much and there are risks. But her pain continues to worsen fast and now she can’t move. They’ve given her morphing and a pain patch and it’s only taking her down a tiny bit. Any help or direction would be greatly appreciated 

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Hi Searching.  Is your mom still in the hospital? Has she seen a pulmonologist? That would be my suggestion. I'm not a doctor, but what she has doesn't seem typical of lung cancer. Most lung cancers don''t cause any pain until they are advanced, and an advanced cancer would likely show up on the CT. High WBC can indicate infection. Seems like she needs to be seen by someone else since the doctors she's seen haven't found the source of the pain.

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I have a family member who has had her pleural fluid drained 3 times and tested for cancer 3 different times and it has come back 3 times showing no cancer cells yet the dr keeps

telling us they still think it is secondary breast cancer had ct scan and PET scan all showing no cancer how can it still be cancer??  we are now having a drain tube put in and

a biopsy done  nest week, do not know where to turn next if it is cancer why is it not showing yet

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29 minutes ago, Siri said:

I have a family member who has had her pleural fluid drained 3 times and tested for cancer 3 different times and it has come back 3 times showing no cancer cells yet the dr keeps

telling us they still think it is secondary breast cancer had ct scan and PET scan all showing no cancer how can it still be cancer??  we are now having a drain tube put in and

a biopsy done  nest week, do not know where to turn next if it is cancer why is it not showing yet

 

30 minutes ago, Siri said:

I have a family member who has had her pleural fluid drained 3 times and tested for cancer 3 different times and it has come back 3 times showing no cancer cells yet the dr keeps

telling us they still think it is secondary breast cancer had ct scan and PET scan all showing no cancer how can it still be cancer??  we are now having a drain tube put in and

a biopsy done  nest week, do not know where to turn next if it is cancer why is it not showing yet

 

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