My dad was dx with nsclc stage 3b in feb 2012
He had intense chemo radio which was successful in shrinking the tumour. However last year it began growing again and he began treatment.
Today he had a ct scan and was meant to have his onc appointment in 2 weeks. However on the scan today they saw his lung has collapsed and is surrounded by fluid. They have told him to go back Friday and have the fluid drained!
So he has seen the specialist and they are doing nothing! They said there doesn't seem a point as the lung will not rebuild and the fluid will keep coming. The other day they thought he had about 3.5litres of fluid today they did and ultra sound and said it doesn't look that much! They also think the fluid is coming in from the bottom! They think it's my dads tumour causing his symptoms!
My dad was dx in feb 2012 he has had 2 lots of chemo- first with radio and that shrunk it but then it began to grow. His chemo finished last time in December last year. It hasn't been confirmed as he hasn't seen his onc but I am fearing it is not good news.
My dad now has to wait to see his onc on the 13th February that is ages away. He has rang and spoke to his oncologists secretary to get advice but the onc is off next week so my dad won't see him then.
It sounds so wrong that they are leaving my dad with this fluid. Everything I have read people always have it drained unless there is hardly any which isn't the case!!! Are they giving up on him?!
My dad is 53 and is still active, working full time and tolerated treatment with no problems so what are they doing?!
Reply # - January 24, 2014, 01:48 PM
Reply To: My dad have they given up?
knic,
Without having all of the information available to your dad's doctors, it's not easy to know exactly what is going on. But usually a buildup of fluid (pleural effusion) is drained to alleviate symptoms such as shortness of breath and chest pain. A large effusion can cause shortness of breath because it does not allow that part of the lung to inflate fully, and causes pain when the lung tries to inflate and the fluid pushes against the lung and the chest wall. In your dad's case, if the part of your dad's lung that is near the effusion (or the whole lung) is collapsed, then that inflation process is not occurring and the effusion is not causing symptoms. If the specialist feels that the lung will not reinflate, then there may not be a reason to drain it, if he feels it will only recur. You may want to clarify the situation with the specialist.
Dr. West's introduction to pleural effusions may be helpful: http://cancergrace.org/lung/2007/03/17/intro-to-pleural-effusions/ as well as his post on their management: http://cancergrace.org/lung/2007/03/18/mpe-managment-options/
I'm sure his doctors have not given up on him...it is more a question of not recommending a procedure that is unnecessary, since all procedures carry some risk.
JimC
Forum moderator
Reply # - January 24, 2014, 06:22 PM
Reply To: My dad have they given up?
I agree that I would not presume that his doctors are just dismissing him. A lung can be collapsed and there can also be fluid visible, yet the situation can potentially be one in which draining isn't the right approach. Sometimes the fluid is really actually pretty limited and just a bystander, with the symptoms truly caused by solid tumor leading to the symptoms directly or leading to the collapse of the lung, which in turn causes the symptoms. But if there isn't a large amount of freely flowing fluid, it's not likely that removing it will treat the problem effectively (sometimes there is pleural fluid that is "loculated", meaning that it is in small pockets rather than one big pocket). So sometimes there are very good reasons to not reflexively remove fluid, even when it's seen and a patient has symptoms.
I don't know if it's feasible to pursue another opinion in the time before his oncologist returns, but if so, that might be a good way to get some reassurance that he isn't being undertreated.
Good luck.
-Dr. West