Round Table with Drs. Anne Tsao and Alex Farivar, Part 2: Mesothelioma

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This is part 2 of my round table case discussion with Dr. Anne Tsao, a medical oncologist and thoracic oncology expert from MD Anderson Cancer Center in Houston, and Dr. Alex Farivar, a thoracic surgeon with expert training in mesothelioma at Swedish Cancer Institute in Seattle. This particular case covers a patient with a mesothelioma, cancer of the lining around the lung, which is also known as malignant pleural mesothelioma.

Here is the audio and video versions of the podcast, along with the transcript and figures.

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Interview Podcast: Dr. Eric Vallières on Pre-Operative Work-Up and Surgery for Lung Cancer

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I'm very happy to present an audio interview with Dr. Eric Vallières, an excellent thoracic surgeon and Surgical Director of the Lung Cancer Program at Swedish Cancer Institute. Within the lung cancer community, he actually happens to be among the most well known thoracic surgeons in the country and even world, and he has a major expertise in the integration of chemotherapy and other systemic therapies for early stage lung cancer.

SCLC with Pleural Effusions: Is there Benefit to Adding Radiation?

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In my earliest introductory post about SCLC, I described the typical staging breakdown used clinically, which is essentially divided into limited disease SCLC (LD-SCLC), which is typically treated with chemo and chest radiation together, with curative intent, and extensive disease SCLC (ED-SCLC), which is typically treated with chemo alone and is not considered conventionally curable.

Options for Managing Recurrent Pleural Effusions

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Between 7 and 15% of patients with lung cancer develop a malignant pleural effusion (MPE), a fluid collection outside of the lung in the chest cavity. Very often, if it develops, it recurs frequently. This is typically associated with shortness of breath, also know as dyspnea, so we want to try to manage these recurrent pleural effusions to minimize pulmonary symptoms (although some lung cancer patients have several reasons for shortness of breath and cough and still have symptoms even with effective management of an effusion. We’ll review several ways to manage this problem.

Introduction to Pleural Effusions

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Pleural effusions related to lung cancer are quite common, so it's time that I discussed this issue. First, a pleural effusion is fluid outside of the lung, and it tends to follow gravity and pool at the bottom (base) of the lung, primarily along the back. Here's how it appears on a chest x-ray, filling up the bottom of the left side of the chest. The right side, in contrast, is mostly black, which is the way lungs should appear on a chest-x-ray (but not in real life, we hope).