Malignant pleural effusion - 1245867

pettelly
Posts:1

My dad just came for a vacation. He was feeling a bit breathless and we took him to er where they found a massive bloody pleural effusion which was fond to be malignant.
So far the diagnosis is adenocarcinoma but they don't know where from. Most probably lungs (ex heavy smoker) but maybe elsewhere. There is no tumor in the lungs ut his kidney function was too weak for a contrast ct.
He needs to be stabilized to go home for treatment (Israel) as his insurance won't cover treatment here obviously.
Is this definitely stage 4? Is there really no cure at all? He seems to well and in such good health apart from this. what are the recommended next steps?
Thanks

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Reply # - July 26, 2012, 01:27 AM

certain spring
Posts: 762

Sorry to hear about this. It must have been a big shock for everyone. While you're waiting for a doctor to deal with your questions, I wanted to offer a little background that might be helpful.
It is not uncommon for someone to be diagnosed with lung cancer from a malignant pleural effusion - although it's also quite common for doctors to have to hunt for the primary tumour. It is great that your father is in good health, as that will help him weather any treatments he needs.
As you'll see from the links below, there are various procedures that can be done to drain or absorb the fluid:
http://cancergrace.org/lung/2007/03/17/intro-to-pleural-effusions/
http://cancergrace.org/lung/2007/03/18/mpe-managment-options/
After that, it would be up to his doctors in Israel, but they might give your father chemotherapy or a "targeted" drug such as Tarceva - something that aims to treat the whole body (called a "systemic" treatment).
I'll leave your stage IV question for the doctors. But if that were to be the case, it's important to remember that "no cure" doesn't mean "die tomorrow". There are lots of people on this site living happy and useful lives with cancer that is technically stage IV. Best to you and your dad.

Reply # - July 26, 2012, 09:17 AM

catdander
Posts:

Dear Pettely, Welcome to Grace. Certain Spring has provided good information for you. I have pasted a comment from Dr. Weiss from a previous post. Also in the post can be found a link to an into to lung cancer and other helpful info. Our search feature is quite good also.
http://cancergrace.org/forums/index.php?topic=9340.0

Dr. Weiss explains, "A malignant pleural effusion defines stage IV, just the same as, say, a bone metastasis. Pleural effusions can create shortness of breath and cough. You can learn more about pleural efussions athttp://cancergrace.org/lung/2007/03/17/intro-to-pleural-effusions/ and their management athttp://cancergrace.org/lung/2007/03/18/mpe-managment-options/

In addition to draining effusions, chemo, particularly avastin-containing chemo, can dry them up by knocking the cancer down.

I have many patients with malignant pleural effusions who have done well for a long time. Like patients without effusions, when the cancer is slow growing and/or our drugs work well, patients can have long duration of life with good quality. When the cancer moves quickly and the drugs don't work, things are less happy, regardless of presence or absence of pleural effusion."

Please know that we will be happy to help with any input we can.
I hope your dad does very well,
Janine
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Reply # - July 26, 2012, 02:00 PM

Dr West
Posts: 4735

Yes, as Janine as highlighted, a malignant pleural effusion makes it stage IV and really not realistically curable, except perhaps in extremely rare cases (enough to say "never say never", but not more than that). The standard approach is systemic therapy such as chemotherapy or an oral targeted therapy, depending on whether a person has a "driver mutation" or not (they are seen in about 15% of NSCLC).

It may be possible to identify the origin of the cancer based on the pattern of proteins on the cancer cells: this is a technique called immunohistochemistry, or IHC.

If it turns out to be NSCLC, here is some information about the basic approach for advanced NSCLC that would be followed just about anywhere:

http://cancergrace.org/lung/2010/04/16/introduction-to-first-line-thera…

-Dr. West

Reply # - October 30, 2012, 03:05 PM

onur d.
Posts: 2

Dear Doc's,

Is there any particular chemo agent that indicates higher success in drying MPE?

Dr. Weiss mentioned earlier that avastin containing chemo could do help. http://cancergrace.org/forums/index.php?topic=9340.0

My dad recently developed MPE seven months after the radio-surgery treatment. Our local onlocogist is not inclining towards avastin due to existing coronary artery disease. We are searching for the next chemo option now. Pleurodesis is on horizon (once daily fluid collections drops).

Warm regards,
Onur

Reply # - October 30, 2012, 03:22 PM

Dr West
Posts: 4735

No, there really isn't any one treatment that has been more successful than others. If the cancer responds to the treatment, the effusion often improves significantly, but there isn't one specific systemic therapy that is recognized as being particularly effective for a pleural effusion.

-Dr. West

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