My stepmom was diagnosed in Dec. 2014 with Stage IV Breast Cancer (without an actual breast tumor). A chest x-ray showed a very large rt. pleural effusion. She had two thoracentesis done and then had a Pleurex catheter placed in January. The fluid from the effusion was sent to cytology and that's how the diagnosis was made. She started chemo in January and latest cat scan shows improvement with no lymphadenopathy, improved hepatic mets, 3mm pulmonary nodule at base of rt. lung and one small spine mets that is stable. So, overall improvement and nothing new.
She still has the Pleurex and it is still being drained every 4-5 days with ~300ml each time. A couple of times it's only been ~100, but it varies. They asked the oncologist about this today because she would really like to get rid of the Pleurex catheter and was hopeful that she would be able to at some point, but the fluid won't stop. The oncologist didn't really have an answer as to why the fluid keeps building up if there is so much improvement.
My question is: Is it "normal" to see long-term fluid production where the Pleurex catheter would be in for 6+ months? Are there any hopes that it could ever be removed? Is there an explanation as to why there is still fluid accumulation?
Thanks.
ETA: I did use the search function and found a lot of information regarding both Pleurex catheters and pleural effusions in general, but did not see an answer to my question.
Reply # - June 16, 2015, 06:29 AM
Hi iradi,
Hi iradi,
Welcome to GRACE. It's good to hear that your stepmom has done so well with her treatment. With regard to the continuing effusions, the problem is that the fluid buildup is not necessarily caused by cancer cells, but by the friction resulting from the two surfaces in the pleural space rubbing together. Initially, the effusion was caused by the presence of cancer cells, but now it may simply be scarring which causes the fluid to recur. That's why an increase in a pleural effusion is not usually considered hard evidence of cancer progression.
JimC
Forum moderator
Reply # - June 17, 2015, 07:00 PM
Thank you for the explanation
Thank you for the explanation and also your last sentence. So, the fluid buildup could occur indefinitely? Is there ever an end to it without some sort of intervention? Is there anything that could or should be done? She is so tired of having that catheter sticking out of her side:)
Reply # - June 18, 2015, 07:49 AM
Hi iradi8,
Hi iradi8,
It's possible it could resolve, but a further intervention may be possible and desirable, such as a pleurodesis, a procedure in which a substance is inserted into the pleural space in an effort to cause the layers of the pleura to stick together, eliminating the friction which causes the fluid to build up. You may want to read Dr. West's post on Options for Managing Recurrent Pleural Effusions.
JimC
Forum moderator
Reply # - June 18, 2015, 08:02 AM
Thank you, JimC.
Thank you, JimC.