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Scary side effect of Tarceva & Malignant Fluid


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My mom has been on Tarceva for 19 months and has tolerated it well. It has done it's job (except in the brain) and kept her cancer at bay. A few weeks ago we had to take her to the ER - her lung had collapsed and was almost entirely filled with malignant fluid. She just had Pleurodesis surgery, she's in a lot of pain now and recovering slowly. Doc says this fluid is one of the side effects of Tarceva. The doctor is still keeping her on Tarceva, but is now adding ALIMTA to her treatment - has anyone had a loved one that has had Alimta or has had this malignant fluid? This was a really scary situation and I want to make sure this isn't a end of life stage - I want to make sure my mom is around for a long time!

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Hi Steph,

My husband never had the problem with Tarceva. He has ongoing problems with pleural effusion from other drugs and the cancer itself. His left side fluid recently did become malignant. He also had partial collapse of his right lung after one of his 21 thoracentesis procedures, but didn't cause much pain. It sounds like your Mom had pleurodesis done. That permanently seals the pleural space between the outside of the lung and the pleural lining of the chest wall. That is where the fluid accumulates, not inside the lungs. Lung collapse on a major scale can be a very scary experience and I'm sorry.

My husband is in end stages of his fight, but I've seen many people who present initially with malignant effusion, so this doesn't have to mean the end for your Mom. Obviously the Doctor thinks the Tarceva is still working for some of the cancer. I hope the addition of Alimta will help in the fight. There are also many other agents that it doesn't appear she has done.

Take care,


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Common causes of pleural effusion are cardiac failure, tuberculosis, pulmonary embolism (blocked pulmonary artery), metastatic disease (cancer that has spread to the pleurae), lymphoma (cancer in lymphoid tissue), and trauma. Less common causes are liver and kidney disease, viral and fungal infection, mesothelioma (benign or malignant tumor originating in the mesothelial cells; malignancy is associated with exposure to asbestos), and adverse drug reaction. Pleural effusion also can occur as a complication after heart surgery.

Hemothorax (pleural effusion with blood in the accumulating fluid) is caused by trauma. Chylothorax, pleural effusion with chyle (lymph and fat) in the accumulating fluid, is caused by neoplastic disease (cancer) and by trauma that impairs the lymphatic draining system


http://www.pulmonologychannel.com/pleur ... ptom.shtml

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Yeah Steph, a pleural effusion can happen early on. I hope your mom has a fast recovery. I have read that the talcum powder they use to seal the pleural lining to the lung can in itself act as an anticancer agent.


I have never heard that a pleural effusion can be a side effect of tarceva. I think I will ask Dr. West about that. I may be going on tarceva in 2 months.

Don M

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