How are Malignant Pleural Effusions typically treated

What is the treatment of Malignant Pleural Effusions?
What is the treatment of Malignant Pleural Effusions?

Malignant pleural effusions frequently manifest in advanced or unresectable cancer stages or during the terminal phase of the disease. The primary aim of treatment is typically palliative, focusing on symptom relief and enhancing the patient’s quality of life. Treatment strategies are tailored based on various factors, such as prognosis, patient preferences, functional status, primary cancer type, and prior treatment history.

Symptom management for malignant pleural effusions may involve several approaches:

  • Thoracentesis:
    This involves draining fluid from the pleural cavity using a needle or a thin, hollow plastic tube. While it can provide short-term relief from severe symptoms, the effusion tends to recur within a few days. Repeated thoracentesis carries risks such as bleeding, infection, lung collapse, fluid accumulation in the lungs, and low blood pressure.
  • Pleurodesis:
    Pleurodesis is a procedure aimed at obliterating the pleural space to prevent fluid accumulation. After draining the fluid via thoracentesis, a substance is introduced into the pleural cavity through a chest tube to induce scarring and closure of the space. Chemical agents like bleomycin or talc are commonly used for this purpose.
  • Surgical Interventions:
    Surgery may involve the insertion of a shunt (tube) to redirect fluid from the pleural cavity to the abdominal cavity, where it can be more easily drained. Alternatively, pleurectomy, which entails removing a portion of the pleural lining of the chest, may be considered.

These interventions aim to alleviate symptoms associated with malignant pleural effusions, contributing to the patient’s comfort and well-being during the course of their illness.