pleural effusion - 1246375

I can't explain why one area responded better than another, except that we know that there can be heterogeneity in the molecular characteristics of the cancer and, with that, the degree of responsiveness to treatment. It's possible that this is from something other than cancer, though in the majority of patients with lung cancer and an effusion, the lung cancer is the underlying cause.

Here' is a link to the management options for a pleural effusion:

http://cancergrace.org/lung/2007/03/18/mpe-managment-options/

Good luck.

-Dr. West

Okay i find myself at a point i was not expecting! since my surgery every CT has been NED and still is as of my july and Oct. CT. but on the July CT they comment on some plurel fluid accumilation. and then as of my Oct. CT it had accumilated. my ONC scheduled a drain of my lung. Was not aware of what this meant! 40centimeters was removed. since then I have gone online and am aware of what all this means. so Now I am very worried! I should say that the surgeon told my husband that there was some fluid in my lung at the time of surgery. was this a precursor to what is happening now? I was very layed back before looking online. I don't see my ONC for a couple weeks so I am kind of upset!

The fluid can be "reactive" after treatment, or it can be from the cancer itself. Your oncologist will need to tell you whether there are cancer cells in the fluid -- that is what is important here. If so, then that would mean that there is active cancer. However, if not, the fluid could just be a product of an inflammatory reaction to treatments you've received.

-Dr. West

I did have Radiation that ended in March. So this could be from that? I'm definately looking for reasons to remain positive. I think my Lung Dr. will probably have the test results when I see him on the 29th of Oct. I know it is real easy to stay positive when things are going good, but much harder when something pops up! Guess I need to find a way to keep my mind off of this until I find out which it is! I am breathing better since having the fluid removed! Thanks for the info. Dr. West! I do feel a bit better!

Yes, radiation could lead to a reactive process associated with a pleural effusion, although it usually won't become very large, just small to medium size, if it's a reactive process.

Good luck.

-Dr. West

Well I'm not sure where I'm at but they called to day to schedule appointment with my Oncologist because the fluid was positive for Cancer Cells. I need to know what are my options at this point? This is what I do, I need to know what my options are and aren't.

I'm very sorry to hear that. With cancer cells in the fluid, unfortunately it's essentially the same situation as metastatic NSCLC. Treatment is given to prolong survival, but we can't realistically expect to cure it. Still, further treatments can be helpful, and this is essentially how we approach it:

http://cancergrace.org/lung/2010/10/04/lung-cancer-faq-2nd-line-nsclc-o…

It'll be important to discuss the specific options and recommendations with your oncologist. Good luck.

-Dr. West

I already have lost half of that left lung, would surgery be an option to remove more of it or even all of it? Just looking for answers! Thanks Dr. West!

No, surgery wouldn't be expected to offer any benefit. The cancer process is systemic when there are cancer cells in the pleural fluid, so the cornerstone of treatment also needs to be systemic.

-Dr. West

Was scheduled to start Chemo on the 12th of Nov. but my ONC called with test results positive for ALK mutation so instead starting on Oral Meds same Date. Waiting on Insurance approval. I don't have all the info yet. Waiting on Nurse to call for appointment for training on the New Oral Meds. Feeling fairly positive. Will fill in as soon as I get info!

Oh Aunttootsie, that's really good to hear!

Would you mind if I split this conversation to its own thread? I could start with your last post about ALK.

Everybody has the ALK these days, it seems! Aunttootsie, I am so glad that what seemed like bad news has a good side to it. I am guessing the oral meds will be Xalkori (crizotinib), which seems to work really well for people with the ALK. So you've every reason to feel positive! all best.

That's great. You can learn more by looking for info here or elsewhere about XALKORI, which is also known as crizotinib.

We look forward to hearing how your treatment goes. There's good reason to be hopeful about it.

-Dr. West

Sure you can split it off! Thanks everyone! Didn't mean to take over this page!