Pleural Effusion/Malignant Pleural Effusion in Childhood Cancer

Pleural Effusion

Symptom Management, Palliative Care, or Supportive Care to relieve side-effects is an important part of cancer care and treatment and should always form part of the overall treatment plan.

Pleural Effusion is a build-up of extra fluid in the pleural space, which is the space between the lungs and the chest wall. Around 50% of people with cancer develop a Pleural Effusion.

A Malignant Pleural Effusion is when cancer grows in the pleural space. In excess of 75% of individuals with a Malignant Pleural Effusion have Lymphoma or Cancers of the Breast, Lung, or Ovary. This condition is considered a sign of Metastatic Cancer, or cancer that has spread to other areas of the body.

Although a Malignant Pleural Effusion is treatable, it can be a serious, potentially life-threatening condition.

 

Symptoms

Relieving side effects is an important part of total cancer care and treatment, which is why you should discuss any symptoms your child is experiencing, new symptoms and changes in symptoms with their Oncology Team so that they can work out a regimen of palliative or supportive care for them.

Individuals with a pleural Effusion may experience the following symptoms:

  • Dry cough
  • Generally feeling unwell
  • Heaviness or tightness in the chest
  • Inability to exercise
  • Inability to lie flat
  • Pain
  • Shortness of breath

 

Diagnosis

Your child’s doctor may schedule one or more of the following tests to find the exact location of the Pleural Effusion, help diagnose a Malignant Pleural Effusion, or plan treatment:

  • A Physical Examination
  • A Chest X-Ray
  • Computed Tomography (CT or CAT Scan)
  • Ultrasound
  • Thoracentesis (the removal and analysis of fluid from the pleural cavity with a needle)

 

Management/Treatment

A Pleural Effusion often requires treatment in a hospital or clinic. The most common treatment is to drain the malignant pleural fluid.

Drainage of the Pleural Fluid can be done in several ways:

Thoracentesis – the removal and analysis of fluid from the pleural cavity with a needle

Tube Thoracostomy – a tube is inserted into the chest for about 24 hours to drain the fluid. This is usually followed by pleurodesis (a process that uses substances such as talc, to try to get the edge of the lung to stick to the chest wall to decrease the chance of the fluid returning).

Catheterisation – The insertion of a small tube, called a catheter, placed temporarily into the pleural space that allows you or your family member to drain the fluid into a bottle as needed or directed.

Shunt – The insertion of a shunt, which is a device used to bypass or divert fluid from one place to another to drain excess fluid.

Chemotherapy – Treatment of the cancer with chemotherapy to prevent the effusion from returning.

 

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