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Pleura of Lung?

fight
Posts: 3
Joined: Jan 2007

I was curious is anyone out there has cancer that has affected the pleura of the lung? It seems like all the stories I see about lung cancer have to do with tumors in the lung. My lungs appear clear with the cancer starting in the pleura of my right lung. Just wondering if there was anyone out there with a similar presentation?

reinstones1's picture
reinstones1
Posts: 92
Joined: Feb 2006

Yes. My mother was diagnosed 12/05 with NSCLC after an xray showed she had a pleural effusion (collection of fluid within the pleural space). The fluid contained malignant cells and the cancer was determined to have spread to the lining of her lung. (she also has tumors IN her lung).

Be aware that cancer cells in the lining of the lung irritate the pleurae (there are 2 layers-- visceral and parietal pleura), and the irritation causes the body to produce fluid. If you haven't yet experienced shortness of breath or a "sandbag" feeling in your lung, try to be aware of it, as it may be an indication that fluid is collecting and compressing your lung.

My mother has had to have fluid removed from her pleural space (called thoracentesis) repeatedly over the last year.

Hang in there.

fight
Posts: 3
Joined: Jan 2007

Thanks for the reply. I was beginning to think my case was more unique than I thought. I had the pleasure of having a thoracentesis on my birthday last September. They drained over a liter of fluid! Still to this day I don't know how I never noticed it. What kind of treatments has your mom been through? I'm currently going through chemo.

reinstones1's picture
reinstones1
Posts: 92
Joined: Feb 2006

Hi. My Mom had chemo for a year straight. From 1/06 to 5/06, she had carboplatin and Taxol. From 6/06 to 12/06, she had Alimta. Her chemo stopped in mid-December, for many rasons, but mostly because her health has taken a big downturn and she didn't feel up to continuing chemo.

We've had some bad news this week-- spread to her spine and the lining of her abdomen. She had a thoracentesis and a pericentesis yesterday-- pericentesis being needle aspiration of fluid in her belly.

She can no longer walk, due the pressure being caused by the spinal tumor. She started a 10 day course of radiation yesterday,in an effort to shrink the tumor and enable her to walk again.

My Mom really has had a "good run" of it-- but now things seem to be going down hill for her and us.

Wishing you the best.

JanQ's picture
JanQ
Posts: 238
Joined: Jan 2004

I was dx with ovarian cancer Dec. 2003. I had a recurrence and just finished chemo on Dec 29, 2006. Following a cat scan of abdomen and pelvic they found a small amount of fluid in my right lung and a tiny amount in my left lung, which they called pleural effusion ( I had never heard of it)so now I have a chest x-ray and a cat scan of just my chest in the morning, not sure what happens next.... never expected this especially since I had just finished chemo. If you don't mind my asking how do they go about draining the fluid??
Good Luck and God Bless

fight
Posts: 3
Joined: Jan 2007

I had a thoracentesis. I am not sure if my experience is the same as other people but what they did with me is numb my lower back on the right side and then they put a needle into my back that was connected to a large bottle and via gravity it pulled out all the liquid on my lung. The most pain I felt was when they had pulled out all the liquid...it felt kind of like a really bad side ache. The pain subsided quickly though. I hope everything goes well for you!

Good Luck and God Bless

ernrol's picture
ernrol
Posts: 91
Joined: Apr 2006

I had stage IV plus a pleural effusion. I have been cancer free since November 2005. My story is posted Lung Cancer Support Community along with a lot of the things I did and still do Put LCHELP.ORG in your browser. This will take you to the web site, then click on Message Board, click on MY Story, Then click on Ernie’s story stage IV. After you read my story you will be able to contact me through that web site.

Stay positive,

Ernie:

kaitek
Posts: 156
Joined: Aug 2006

Hello everyone,

First for reinstones1, I am truly sorry to hear your mother hasn't been doing well. I consider all lung cancers especially of stage 3 and 4 to be comrades-in-arm. Those stages are particularly difficult to combat but not insurmountable. So when lung cancer patients are victorious I am joyful with them; just the same it's sad to hear when one isn't making progress or regressing. I honestly feel for you and hope the radiation treatments produce better results. Best of luck and my best wishes to your mom and you.

To answer your query fight, my mom has pleura effusion in her lungs. It was the primary symptom that necessitated medical attention because the fluids compressed her right lobe and made it very difficult for her to breathe. We had to go to the ER on 3 separate occasions to drain about 1 liter of fluids into a bottle via gravity and mainly the vacuum in the bottle (to answer JanQ's question), and 1 tapping (aka thoracentesis) was scheduled at the pulmonologist's office where the doctor drained the fluids by hand pumping (that is more comfortable for the lungs as the lungs don't expand as rapidly back as with the vacuum method). The tappings were about 1 week apart and 2 weeks at most. (It didn't take long for the lungs to refill enough to impact the breathing.) From there, the pulmonologist decided a pleurodesis was needed. This procedure involved inserting talc between the lung linings to irritate them enough to seal together. The thoracic surgeon gave a 85% success rate, but our oncologist said it was lower. My mother has pockets of sacs so fluids are still collecting (but not much). Her breathing is heavy but not too labored, so there is no need for draining (which would be more tricky with the sealed linings).

During the pleurodesis, a biopsy was done and that was when we learned in addition with the PET scan that she had cancerous cells in her lymph nodes in the center of her lungs, tumor mass of 6 cm in the right lobe and cancer in her right hip. The cancer spread to 4 locations.

Since the first week of August, my mom has undergone 22 sessions of chemotherapy of the combination of carboplatin and taxol. She has tolerated the chemo pretty well but the buildup has taken a toll on her blood count for both red and white cells. She's given a booster shots for those every other week. At one time her platelets were getting low so she was given a week off. We found out that the combination of ginger and garlic might have been the cause. (When she abstained from both, her platelets were fine.)

Anyway, don't be too alarmed by the low blood count. There are boosters and if you're stringent on hygiene, it should minimize the infection risks.

We were told chemo response rate was only 25%. That didn't discourage us but I made sure I supplemented the chemo with dietary components of cruciferous vegetables (favoring broccoli, radish & daikon), minced raw garlic clove, 200 mcg of selenium, and vitamin D3. The routine has been modified throughout the therapy with my concerns either allayed of soy or raised of the countereffects of multivitamins (they are antioxidants when chemo works on oxidants). Initially, my mom was taking multivitamin on the post-chemo days. I eliminated that sometime mid-course, but added the vitamin D3. Recently, I've added soy into the picture because the genistein in soy acts much like the targeted cancer drugs in promoting cancer cells death (apoptosis) and prevent growth of blood vessels for cancer cells (angiogenesis). (Excuse any misspellings of medical terms.) My initial concern about soy was its estrogen effect on cancers that have estrogen receptors that may boost the growth of cancer cells. That's mainly with breast and ovarian cancer cells. I decided to go with soy on a moderate scale. (1 cup of soy milk a day or 1/2 cup of tofu.)

Other additions are chili sauce or red pepper flakes (capaisin apparently kills cancer cells), tomato products (juice and salsa) and sugar-free raspberry jam (raspberries have the highest concentration of ellagic acid, a cancer-fighting ingredient). Mainly, we're focusing more on foods than synthetic supplements. I am thinking about D-extract from maitake mushrooms, which purportedly have powerful anti-cancer agents. Apparently, the D-extract has protective property against the side effects of chemo. I'm on the fence because it's not readily available in the grocery store like the other foods.

Anyway to give you an idea of how well my mother has been doing with all of that, her primary tumor in her right lung has shrunk by two-thirds - with similar reduction in the pleura, the cancer cells in her lymph nodes and hip have disappeared, and SUV values (reflecting cancer activity) has decreased from 27 to 5 (normal is 2 and under). Those are the results from the latest PET scan. It's very encouraging.

I have to confess that I was a bit concerned that many survivors recovered on a protocol of surgery with chemo/radiation or a triple-combination chemo with a targeted drug (e.g., Tarceva). So, this is a relief that a simple two-combination chemo of Carbo and Taxol (plus maybe enhancements at home) is effective. My mother is continuing with Carbo and Taxol. I asked about adding Avastin to the regiment and her oncologist was agreeable to the change.

Sundanceh's picture
Sundanceh
Posts: 4339
Joined: Jun 2009

Hi, I just finished up a P.E.T. scan that showed 2 spots on my pleura. I've also got a big lump sticking out of my rib cage. One spot showed no uptake, but the other spot did. My lungs are also clear, except for the spots and the new lump. I'm seeking a second opionion this week and do not know what to think just yet. We've talked about possible radiation to the area - and the possibility of a thoractomy, which is a pretty bad surgery.

I started out with colorectal cancer, which metastasized to the liver, and now apparently to the lung. I'm 5-years into my fight and much of what I've read is what people are going through - many surgeries, chemotherapy of all kinds, radiation, and CyberKnife radiation. Most of the markers show good, except for the CA-19, which is off the charts, but we can't find anything in the pancreas.

We were watching one spot from a few scans ago and it got bigger, so we setup a PET, and then found the other spot, which has uptake from the scan, but did not appear on the CT. It's hard to get a straight answer from the doctors - they are just not sure.

Decided to go to UT Southwestern for another opionion, before deciding on the best course of action.

sbmdpc
Posts: 4
Joined: Mar 2009

I also have cancer in my pleura. I have had the fluid drained three times. Since starting chemo in April I have not had to had the fluid drained again. My pleura tumor is currently pressing against my rib cage on the right side causing considerable pain. My cancer has metastasized to my adbomen, brain and thymus.

ARobben's picture
ARobben
Posts: 46
Joined: Apr 2009

Fight,
My Cancer (Stage IV NSCLS) also presented in my pleural space. The doctors at first weren't sure if the cancer began there and penetrated both my lung and chest wall, or if it began in the lung and just spread outward.

I also had pleural effusion and had a significant amount of fluid removed. For me, they just did it with a syringe and it felt extremely weird afterwords as I felt my lung expanding back into the space that had previously been taken up with fluid.

Looks like there are plenty of us on here who can relate to the way your Cancer presented itself! You're not alone!

kjmconway's picture
kjmconway
Posts: 7
Joined: Jun 2009

I am new on here, and I have read many of your postings. But the one thing that you have continually said that is a comfort is "YOU ARE NOT ALONE"
It isn't because I wish this on anyone....I sincerly wish there was a magic pill that we all could take and POOF..it'd all be gone. But just with what I have been through thus far, not even looking down the road...many do not know what to say, or how to react, I seem to have misplaced some of my good friends along the way, ot they misplaced me.. Simply, those four words mean so much,
You are sure positive, as am I. It is scary, it is sad, it is alot of things, but I am strong, as you seem to be too.
I had my upper right lobe removed in May, I hurt everyday, and wonder if this will get better, but I keep on going. I have it in my pleural, and start a regimen of navelbine, and platanol next week. I don't know anything about the fluid and drainage. Is that probably something I need to keep an eye on?
Thank you for your posts, your positive attitude, and the information that you provide.
You too...are not alone.

ARobben's picture
ARobben
Posts: 46
Joined: Apr 2009

I just know it helps to hear that you're not alone, because we can all feel that way. And I think being positive is a choice. I mean, I know the statistics on lung cancer survival rates and all that, and I can wallow up in self-pity, hide under my covers, and never come out...or I can be positive. I choose to be positive.

I have my moments. Do I cry? sure. Do I get upset sometimes? sure. I've even lashed out from time to time. But I know we are all going through a rough experience together and staying positive is the best way to help each other out.

As far as having fluid drained, I guess that would depend on the amount. That's a question for the doctors, but you should never hesitate to ask them anything you're curious about!

Best of luck with the Navelbine and Platanol!

miaculpa
Posts: 1
Joined: Feb 2010

Dr Sugarbaker is a surgeon at Boston's Brigham& Women's Hospital. He pioneered a new surgical procedure to remove the pleura itself, mostly used for mesothelioma; however, a relative of mine just had the procedure to treat cancerous cells in her pleura due to ovarian cancer. Hopefully, this information will be useful to someone out there. Best of luck!

jaminkw
Posts: 6
Joined: Dec 2007

Hope you are still around these boards. I looked and looked after I was dx'd in Oct 2007. Except for the side, mine was in left pleural wall, my case was exactly like yours. No tumor in the lung or anywhere else. My cancer responded remarkably well to the 6 triplet infusions followed by Avastin for a total chemo treatment of one year. I took six months off. I was told to expect it to come back. It did. Got a good run from Avastin and it disappeared again. Unfortunately, it shortly showed again in the lining of my abdomen. Again, no tumor. I've had fluid drained from my abdomen (as I did from my lung) and am now on Taxotere after no luck with Tarceva. I'm lucky I tolerate chemo well and am getting a good run from the Taxotere. Except for fatigue, I'm living well.

Would really like it if you'd post so I can hear how you are doing.

Judy

sierraamber
Posts: 1
Joined: May 2012

Hi Judy,

My original dx was Breast Cancer, 2002. It was treated with chemo and radiation and it went into remission. I took Tamoxifen until 2008. Unfortunately, 6 months later, I had left wall pleural effusion. No tumors but cancer cells were found in the fluid. I was treated with Taxol and Avastin - Taxol for one year and Avastin until now with Arimidex as addtl. hormone treatment. Unfortunately, when Avastin was removed from FDA, insurance stopped paying. Dr. wants to continue with Avastin partly because of uncertainty of what will happen if stopped.

I'm sorry to hear "it" returned and hope your treatment is going well. Is there any recommendation for you to get back on Avastin?

Hope

veganposterchild
Posts: 2
Joined: Aug 2012

i found a natural alternative to avastin. it does the same thing but no side effects. its called Angiostop by Dr. Chi. you can google it and buy it from the online store in anaheim. I started it a few months ago. It is also supposed to help reduce tumors. Another tumor reducer is Laminine. It also helps with pain. my insurance blue cross did pay for avastin but I quit chemo 5 months ago. I am strictly alternative now. I couldnt tolerate the chemo and avastin. I hope this helps.

Booster24
Posts: 11
Joined: Apr 2012

There is also a procedure called a pleurodesis which can take away the need for draining fluid regularly. It's typically done by a thoracic surgeon and is a relatively simple procedure, takes 30-45 minutes, although it requires a couple of days stay in the hospital.

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