Mesothelioma pleural effusion is a common symptom of pleural mesothelioma cancer – the most common form of mesothelioma that affects the lining of the lungs and occurs in 75% of all mesothelioma cases. An effusion is a term used to describe a condition in or around the lungs in which the tissue has become swollen, trapping natural fluids or in which natural fluids are over-produced causing a buildup of fluid to occur. In cases of mesothelioma pleural effusion, the fluid produced in the mesothelium that is intended to reduce friction during breathing when the lungs expand gets trapped in the pleura (lining of the lungs) and is secreted more than in normal.
Most pleural effusions are the result and symptom of congestive heart failure, though it is a common symptom of mesothelioma as well. Many pleural mesothelioma patients exhibit symptoms of pleural effusion or are at great risk of developing the condition. There are two types of pleural effusions; transudative and exudative.
- Transudative effusions are caused by fluid leaking into the pleural space (space surrounding the lungs) and are caused by increased pressure in blood vessels or a low protein count in blood vessels. This type of effusion is most commonly caused by congestive heart failure and is the most commonly reported effusion among all who suffer pleural effusions.
- Exudative effusions are caused by blocked vessels, inflammation, lung injury or trauma, and drug interactions. This is the type most commonly associated with mesothelioma pleural effusion.
Mesothelioma Pleural Effusion Symptoms
Many symptoms are indicative of a mesothelioma related pleural effusion. The most common are chest pain, cough, and shortness of breath. Mesothelioma pleural effusion may also be asymptomatic, showing no signs or symptoms. Asymptomatic cases of effusion are often discovered during routing examinations or tests conducted to discover the cause of another symptom of mesothelioma or other condition.
The most common symptoms of mesothelioma pleural effusion are:
- Chest Pain
- Persistent Cough
- Fever
- Hiccups
- Rapid Breathing
- Shortness of Breath
Any of these symptoms may be indicative of a condition other than mesothelioma pleural effusion, so the mere presence of symptoms does not necessarily indicate that an effusion is developing. To be sure of the cause of symptoms, a doctor will request a variety of tests to determine the cause of the symptoms. When several symptoms are presented to a doctor, it is easier to speculate the cause and therefore easier to determine which types of tests are appropriate. When a mesothelioma pleural effusion is suspected, or when any lung related condition is possible, specialists will recommend at least one of the tests outlined in the table below.
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Testing for Pleural Mesothelioma |
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| Procedure | Details of the Procedure |
| Chest X-Ray | An x-ray is a special imaging technique that allows doctors to see any abnormalities in the chest cavity. Fluid collection and swelling of the pleura are shown on the images, indicating the presence of a pleural effusion. |
| Chest or Thoracic CT Scan | A CT scan of the chest or thoracic cavity works in much the same way as an x-ray, but provides a more detailed image of the lungs by combining the images from various angles, allowing doctors to view cross-sectional images that display the precise location and spread of fluid. |
| Ultrasound of Chest | An ultrasound uses sound waves to create an image that shows the density of the lung wall, indicating the presence of fluid, tissue masses, and swelling of the pleura. |
| Thoracentesis | Thoracentesis is a procedure in which a thin needle is inserted into the pleura to draw out fluid discovered around the lungs. This fluid may also be processed and analyzed in a pathology lab as a form of biopsy. |
| Biopsy | Pleural fluid is collected with a microscopic camera outfitted with special tools that is inserted into an incision between the ribs or through a thin needle inserted between the ribs. The fluid is then analyzed under a microscope to discover bacteria, infection, or cancer cells – the latter of which may indicate a mesothelioma pleural effusion. |
A chest x-ray is most often the first test conducted for a patient that is exhibiting the symptoms of a pleural effusion. If the x-ray proves the existence of a possible effusion, further imaging scans are ordered to determine the extent and location of the extra fluid around the chest. A biopsy is the most conclusive method used to determine if the patient is suffering from mesothelioma or a mesothelioma pleural effusion, specifically.
Mesothelioma Pleural Effusion Treatments
Treating a mesothelioma pleural effusion may be conducted for two reasons; to prevent fluid build-up in the future and to remove existing abundant fluid from the pleural space. Some of the techniques used to reduce fluid excesses or prevent future accumulation include:
- Therapeutic thoracentesis, to remove excess fluids through a thin needle inserted between the ribs and into the pleura.
- Pleurodesis, to insert medication that fills the pleural space and destroys much of it, leaving no space for the future accumulation of fluids.
In most cases, once the immediate cause of symptoms has been removed (excess fluid) doctors will attempt to treat the cause of the effusion. In cases of mesothelioma pleural effusion, however, there is no way to completely remove the cause as there is no known cure for pleural mesothelioma.
Common curative treatments for effusions include:
- Diuretics, if the effusion is caused by congestive heart failure.
- Antibiotics, if the effusion is caused by bacteria and infection.
- Chemotherapy and radiation, if it is a mesothelioma related pleural effusion.
Chemotherapy and radiation are the most common cancer treatments employed during the course of mesothelioma treatment. By using both methods, a technique known as “combo therapy”, the size of tumors and number of cancer cells may be greatly reduced.
Reducing the amount of cancer in the pleura helps to reduce the effects of mesothelioma pleural effusion by reducing pressure on and swelling of the glands that produce the serous fluid naturally excreted in this part of the body. The ability to receive radiation and chemotherapy depend on the patient’s overall health, however. In cases where the patient is unable to tolerate these popular treatments, doctors will seek alternative means of treatment including photodynamic therapy or recommend the patient to clinical trials for gene therapy or immunotherapy.
