Pericardal Effusion - 1261774

luckyrebel,

I'm sorry to hear about the pain you are experiencing. Pericardial effusions can have various causes, and after a diagnosis of cancer elsewhere in the body, that certainly raises a suspicion. The only way to know for sure is to drain the fluid and test it for cancer cells. Effusions tend to be drained when they are causing symptoms such as the pain you're experiencing, so that may be something you want to discuss with your doctors.

When my wife was first diagnosed, she had a mild, asymptomatic pericardial effusion which disappeared during her treatment, showing up occasionally on scans after that. About 2-1/2 years after diagnosis, a larger pericardial effusion appeared and continued to enlarge, causing tamponade (which limits the pumping of the heart and can lead to cardiac arrest). It was drained and did not recur. Although it was presumed that this effusion was cancer-related, no cancer cells were found in the fluid.

I hope you can get your pain under control very soon.

JimC
Forum moderator

Pericardial effusions that are small to moderate are pretty common and are often inflammatory (not directly related to cancer spread). However, if the effusion grows to the point that it compromises the ability of the heart to squeeze blood out effectively, it can cause shortness of breath, lightheadedness, weakness, swelling in the lower part of the body, nausea, and other symptoms. Therefore, effusions are often watched carefully with CT scans and/or repeat echocardiograms, at regular intervals or perhaps based on changes in symptoms. If it's large enough, a pericardial effusion may need to be drained, and it'd be worth checking the fluid to see whether cancer cells are present. If so, it represents recurrence and a more advanced process. On the other hand, it may well be inflammatory, and you may remain cancer free. The only definitely way to know would be to remove the fluid and look for cancer cells under the microscope.

Good luck.

-Dr. West

luckyrebel,

Since we don't have access to all of your medical information or an opportunity to examine you, no one here can advise whether to monitor your effusion or drain it. As Dr. West said, the main reason to drain the effusion would be the effect it is having on your heart (based on symptoms and results of a scan and/or echocardiogram). If it grows large enough, or quickly enough, your heart function may be compromised. If it is drained, as Dr. West said "it’d be worth checking the fluid to see whether cancer cells are present". Although it would be good to know whether the effusion is malignant, and you could drain and test it for just that reason, preventing compromised heart function would be the primary reason to do so.

JimC
Forum moderator

Yes, that decision of whether to drain or follow it is one that needs to be made by the doctors there.

-Dr. West