NSCLC MPE PLEURODESIS FAILED, INSPIRA PLEURAL DRAIN - 1263621

mdmfoo
Posts:1

Hubby, 84, dx'd 12/13 NSCLC presenting with 3+ liter MPE left lung. Carbo/Alimta 3x, several thorantecis, Pleurodesis 3/24 revealed extensive tumors preventing decorticating lower lobe, upper decorticatied but would not reinflate so inspira pleural drain 4/7. Fluid at home went from reddish 300 liters per day to 75 yellowish per day. After 4th Carbo/Alimta 4/23, fluid has increased to 150 per day and very red, bloody. Cat/pet scans prior to pleurodesis have not been revealing due to MPE, and low HBG and platelets have required several blood transfusions and severe fatigue, over 30lb weight loss since dx. I worry chemo is doing more harm than help, with no assurance it is working, unless increased bloody fluid is a good sign?Or bad? No help from oncologist, I just want the best quality with the time we have. And worry about what the change in fluid qty and blood might mean. Thank you for any insight.

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Reply # - May 5, 2014, 07:42 PM

Dr West
Posts: 4735

The effusion, whether increasing or decreasing, is a "soft endpoint" that really doesn't say anything conclusive about the status of the cancer. His weight loss and weakness are more concerning, and it's possible that this could represent progressing disease, or at least clinical worsening, but the clearest indicator of progression is evidence of clear progression of a measurable aspect of the cancer or a new area of disease. Presumably, there isn't much progression if the scan doesn't show any appreciable change, though it's possible for everything to be obscured by the scarring in the pleural space.

-Dr. West

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