should you leave a pleural effusion alone?

[rayroy]

If dad has a pleural effusion, the doctors have said he has, should he get it drained? He has gotten it drained twice. The first time it took 2 days, the second time it was hard on him. It took 7 days or so. The oncologist has never mentioned that it should be drained. I assume it should be, of course I head that there is a risk of infection, but there would be great relief for my dad. He could breath easier. I will call the docs tomorrow to get the ball-rolling!

ray

[cathy]

Ray....Keep us posted on what you find out, my dad is in the same situation and nothing at all has been said about draining...cathy

[Marlon]

Ray,

I would definitely seek to have the fluid problem resolved. And I'll tell you why. In my mom's case, they started her off with an indwelling catheter called a Pleurx drainage kit. It was put it by a pulmonologist. It is basically a tube implanted in the pleural area and when there is too much fluid, you can have someone(like a home nurse in my mom's case) drain it. It certainly wasn't pleasant, but it offers immediate albeit temporary relief. And having it drained every month via thoracenthesis can be painful.

The other option would be to have it surgically fixed. In most cases, they do what's called a pleuradesis, in which they drain the fluid, then if the lung re-expands, they adhere the lung to the chest wall using sprayed talc. It is about 90% effective in preventing future fluid buildup. For me, it was hell having to keep track of my mom's drainage appointments while simultaneously worrying about the effectiveness and side effects of her chemo. Being a member of this board since September last year, I could see the writing on the wall, so I switched her over to Block Center before our local hospital could even mention the word "hospice".

As was my mom's case, untreated pleural effusion can develop into what's called a trapped lung; the malignant pleural effusion eventually caused a membrane to form around my mom's lung, so the lung stays collapsed. It happens in 10% of pleural effusions. This renders a pleuradesis pointless because whether the malignancy still exists or not, the fluid will keep coming back because of the vacuum pocket created by the empty space in the chest. That's why all the doctors we met with initially weren't willing to try anything; they didn't know anything else could be done. To them, trapped lung was synonymous with terminal. When my mom's scans came back clean, and her fluid tested consistently negative for malignant cells, I was determined to find a surgeon good enough to help us.

Luckily, after months I found one of the most knowledgeable thoracic surgeons here in Illinois. It later turned out that she teaches a surgery class! She laughed at how the other doctors ran out of ideas. When we first consulted with her, she immediately mentioned that surgery was an option. She operated on my mom and it was a piece of cake. Mom underwent a pleurectomy, and after a month her lung re-expanded completely. There weren't even any more cancer cells in the pleura they removed. It's been almost three months since the surgery, and my mom is doing fine. She just finished her last chemo on May 19th. Now she will be under close watch. All her first doctors are feeling pretty stupid right now.

It sounds to me that they are taking your dad's age into account, and that may be why they haven't mentioned any kind of surgery. Also, they want the patient to be clear of malignancy first. However please take into account that any surgery, minor or major, is risky and can induce infection. I certainly don't want to worry you because I know you have enough to worry about, but I wanted to convey that after months of gruelling uncertainty, we now have the peace of mind of knowing that my mom no longer has breathing problems, or even any signs of cancer. Right now probably what's going thru your mind is that you want him to be helped, permanently if possible, but you're not sure if the risks outweigh the benefits. I know, I went thru the same thing. It really depends on your dad's choice and his overall condition.

Hope this helps. I can send you my Pleural Effusion research if you want. Praying with you, my brother.

[rayroy]

Thanks Marlon, please send me your pleural effusion research. I talked with an oncologist 2 weeks ago and he said that the fluid can be drained if his fluid was "free-flowing". Dad did have a surgery in November but it apparently failed, the oncologist said it works maybe 60 percent of the time. The main concern is dads breathing problems and also I am sure if the effusion expands to both lungs he will simply drown in his own fluid, am I right or wrong in assuming this about a pleural effusion?

With all surgeries there is risk, but if what will kill my dad is the pleural effusion we have to seek help for this, if he gets it drained he will experience relief maybe for a month, but it maybe better than having him suffer.

Currently the old man can walk around the house, but at times is short of breath. He seems to want to do less and this because of the fluid build up.

The main problem now is dads hmo. Next Monday he will go back to medicare, after that he can be looked at by university facilities or better oncology groups.

This is hard, because nobody in my family(there are 7 siblings) is seeking extra help on his illness. To make it worse one of my brothers doesnt believe that standard medicine will work at all. So if I take Dad to an oncologist my brother feels its awaste of time and that he will just get toxic drugs that will destroy his body more than help. He believes tea and noni juice is all he needs. However, there is no follow up to see if this works. To me it hasnt much. Well, enough babbling, thanks for your input Marlon and do please send me any info you got on pleural effusion.

ray

[Marlon]

Pleural effusions mean fluid is building up outside the lung, between the actual lung itself, and the chest wall. When it builds up inside the lung I think they call it empyema, or pulmonary infiltrate(something or other). Since they attempted surgery on your dad, I imagine it was building up on the outside. The pleuradesis usually only fails if malignancy is still there because the lung surfaces continue to secrete more fluid. Since the fluid stays outside, the person doesn't "drown" so to speak, the compression on the lungs just makes it hard to breathe, and your body produces less oxygen. I don't know what I would have done if my mom had the fluid INSIDE her lungs.

Don't let your brother discourage you. I was very open to alternative medicine as well in the beginning and let me tell you, there's some pretty questionable stuff out there. However from my mom's experience, I do believe cancer patients need complementary treatments(chemo and reasonably alternative medicine that has shown some efficacy). I would tend to stay away from anything TOO questionable(ie, Essiac, Oncolyn, Noni Juice, Hydroxygen).

Think of it this way: if the first chemo regimen didn't work, why would some juice? Chemo's some pretty powerful stuff, and it's not worth the time lost. If you must look at alternatives, try to find a clinic that does both, because the chemos can be more deadly than the cancer itself. I believe that the chemo worked for my mom only because the other supplements she was taking made it less rough on her body, and more of a heat-seeking missile to the cancer cells. I was amazed when the surgeon told us that there were no more cancer cells in the pleura she removed.

Please send me your email because I don't know how to send attachments thru the board. I have a whole lotta info stored as an HTML file.

[rayroy]

Thanks Marlon My email is raysensei27@aol.com. Thanks for your info on pleural effusion. I hope the docs can see him as soon as early next week. Take it easy!

[Marlon]

I have sent you an email from my hotmail account. Take care.

Sensei, huh? What arts do you study? I take aikido and kenjutsu/iaido.