sissy12
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86 year old recently diagnosed with Stage IV NSCLC with a malignant pleural effusion. No treatment chosen due to her age and overall health. Had an indwelling catheter placed 2 months ago. Hospice comes twice a week to drain the fluid. The fluid drained has normally ranged from 500 -600 ml every four days. The last two weeks there has been very little fluid to drain. What, if anything does it means in terms of her condition when the fluid appears to have dried up? Will the pain now be worse? What is happening with her body? Is this a sign she may be headed for final weeks/days?
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Reply # - December 9, 2014, 05:58 PM
Hi sissy12,
Hi sissy12,
I am sorry to hear of this diagnosis. I don't think there is any real conclusion to draw from the reduction in pleural fluid. Sometimes effusions wane regardless of treatment. The excess fluid is created as a result of irritation of the pleura, and the pain (as well as shortness of breath) results from the increased pressure and friction that fluid causes.when the lung expands with each breath.
Normally when an effusion decreases in size there is less pain and shortness of breath, but it is also possible that her effusion has become loculated, a condition in which the fluid is not free-flowing and pooling at the bottom of the lung due to gravity (where it can easily be drained by catheter), but instead is contained in separate pockets which can't easily be drained. In such cases symptoms might remain unchanged since the fluid is still present. Dr. West describes pleural effusions in his post Introduction to Pleural Effusions.
JimC
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Reply # - December 9, 2014, 07:42 PM
I agree. I don't think you
I agree. I don't think you could reliably say it means anything, but as Jim noted, there could be a mechanical reason why fluid isn't coming out. For instance, there could be fibrotic/scarring changes leading to the loculations Jim mentioned, the catheter could be clogged with cellular material/debris, and/or the catheter may have shifted in position and may be kinked. The pulmonologist or other specialist who placed the PleuRx catheter would probably be the best source for further information.
Good luck.
-Dr. West