Stage IV NSCLC Adenocarcinoma with Malignant Pericardial Effusion - 1259806

*** Apologies for misreading your comment the first time and responding about pleural effusions. Here's my revised comments based on pericardial effusions, with some overlap with what I had said previously.

The main treatment for a pericardial effusion is to do a pericardiocentesis, which is usually done by a cardiologist. This involves inserting a needle into the pericardial space now filled with fluid, to drain that fluid off. It is a closely monitored process. The more definitive procedure is then to do a "pericardial window" procedure, in which a hole is deliberately made in the pericardial sac in order to have the fluid spill out of that very limited space and into the pleural space, where the fluid collection can be managed more easily than a pericardial effusion.

Otherwise, the main focus is to treat the underlying disease as effectively as possible. In other words, if the chemotherapy or targeted therapy is effective against the cancer overall, this can lead to the malignant pleural effusion drying up.

There really aren't specialists in malignant effusions. These are just commonly part of the management done by lung cancer specialists, thoracic surgeons, and interventional pulmonologists.

Good luck.

-Dr. West

Hi there,

I had a pericardial effusion at diagnosis. Around 2 liters of fluid were drained and a catheter w/drain inserted for two more days. I began chemo a week after the procedure and responded enough that the fluid didn't return. Hopefully this will be the case for you.

Best wishes,

Jazz

I first started having pericardial effusion prior to being diagnosed with a recurrence in a sub aortic lymph node 2 years ago. I received chemo radiation and the pericardial effusion decreased.

My most recent ct scan showed increasing pericardial effusion which seems to be causing me increased shortness of breath, feeling faint after I cough and weakness in my extremities. I am wondering if there is anything I can do to reverse this condition, short of having it surgically drained.

sak222,

Mild pericardial effusions not causing symptoms are usually left alone, often resolving with treatment. But if you are having the symptoms you describe, it is very likely your effusion needs to be drained. Left untreated, such an effusion can cause tamponade, a restriction of the movement of the heart which can lead to its failure. As Dr. West has said "A pericardial effusion is like having the heart in a baggie with extra fluid, and if there's way too much, it can limit the ability of the heart to move and expand in that space -- a bad thing. So we take this pretty seriously..." and "common symptoms of a pericardial effusion are shortness of breath, racing heart, edema, cough, and lighheadedness or fainting." - http://cancergrace.org/forums/index.php?topic=798.msg4182#msg4182

This is a potentially serious matter which should be reported to your doctor without delay. When my wife experienced these types of symptoms due to her pericardial effusion, I took her to the ER, where an echocardiogram revealed tamponade. Within the hour, she was having a procedure to drain the effusion, which provided almost immediate relief from her symptoms.

JimC
Forum moderator

Thanks, Jim. I was kind of surprised my oncologist was pretty blasé about this. I will contact my cardiologist for an echocardiogram. Thanks again!
Stacy