Management of Pleural Effusions
General approaches and treatment considerations for patients with a pleural effusion from lung cancer
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Webinar on Pulmonary Complications in Lung Cancer, with Pulmonologist Gerard Silvestri
Our next webinar will be with Dr. Gerard Silvestri, Professor of Pulmonology and Critical Care Medicine at Medical University of South Carolina in Charleston. Dr. Silvestri is amazingly dynamic and gave one of my favorite talks that was turned into a podcast, on the workup of lung cancer. He’s terrific with patients and can cover difficult concepts very accessibly, really connecting with his audience.
GRACE and LUNGevity Foundation will be partnering to feature him in an upcoming webinar on Wednesday, May 30th, at 7 PM Eastern, 4 PM Pacific, where he will cover topics of pulmonary complications like pleural effusions, obstructed airways and collapsed lung lobes, and coughing up blood, and of course how these can be managed.
Interview Podcast: Dr. Eric Vallières on Pre-Operative Work-Up and Surgery for Lung Cancer
I’m very happy to present an audio interview with Dr. Eric Vallières, an excellent thoracic surgeon and Surgical Director of the Lung Cancer Program at Swedish Cancer Institute. Within the lung cancer community, he actually happens to be among the most well known thoracic surgeons in the country and even world, and he has a major expertise in the integration of chemotherapy and other systemic therapies for early stage lung cancer. He was also one of the first people to welcome me enthusiastically into the lung cancer world when I was still completing my oncology training, and we’ve worked closely together for the last decade.
Dr. Vallières will be providing a lot of very helpful discussion on the surgical perspective, but this initial podcast focuses on the basics of surgery for lung cancer. It cover the initial pre-operative work-up, general aspects of the different types of surgery for lung cancer, and some on potential complications of surgery for lung cancer.
This interview is being presented in two formats. It’s an audio interview, but there are figures that appear, synchronized with the discussion. The link with the audio is just below, and the podcast link to the vidio version is at the bottom.
Intro to Surgery for LC Audio Podcast mp3 link
Podcast: Play in new window | Download (0.0KB) | Embed
Options for Managing Recurrent Pleural Effusions
Between 7 and 15% of patients with lung cancer develop a malignant pleural effusion (MPE), a fluid collection outside of the lung in the chest cavity. Very often, if it develops, it recurs frequently. This is typically associated with shortness of breath, also know as dyspnea, so we want to try to manage these recurrent pleural effusions to minimize pulmonary symptoms (although some lung cancer patients have several reasons for shortness of breath and cough and still have symptoms even with effective management of an effusion. We’ll review several ways to manage this problem. Continue reading
Introduction to Pleural Effusions
Pleural effusions related to lung cancer are quite common, so it’s time that I discussed this issue. First, a pleural effusion is fluid outside of the lung, and it tends to follow gravity and pool at the bottom (base) of the lung, primarily along the back. Here’s how it appears on a chest x-ray, filling up the bottom of the left side of the chest. The right side, in contrast, is mostly black, which is the way lungs should appear on a chest-x-ray (but not in real life, we hope).
(click to enlarge)
However, pleural effusions can also be loculated, which means that they don’t follow gravity but rather are contained in pockets that are formed from scar tissue, inflammation, etc. Here’s a CT image showing a loculated effusion on the left side, not freely flowing in the chest to follow gravity:
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