Stubborn Pleural Effusion

Jodisgoing180

I was diagnosed in Feb 2016. I had a pleural effusion (how I was initially diagnosed).  Anyway, they drained it and it returned after my hysterectomy. I had the hysterectomy and debulking before chemo. My doctor told me that it would clear up with chemo. It has not cleared up. I have no symptoms. The only symptom i have is some pressure on my ribs. It was worse before, but is slowly lessening. Is the fact I have an effusion still any indication that chemo is not working?  My CA-125 is elevated because of chronic sinus issues, and not a great indicator.  Do I request it be drained again?  The doctor seems unconcerned. 

LorettaMarshall

Jodi~Dr. SHOULD B ordering an XRAY~Tell him U want one!

Hey Jodi ~

My most recent CT scan indicated that I had "pleural effusion".  I asked him what he would be doing about that.  He said, "First we will order an XRAY. That will determine the volume.  Then I suppose it will be drained, and tested of course.  But since I already have "cancer" still present in my body, I would fully expect it to be cancerous.  But that's as far as I have gotten with this new finding.  So below is a web link that will be helpful to you.  Doctors should know that we want good explanations for what they deem "unimportant!"  I think it's very important, and I would tell him that you've read this article, and that you're concerned.  My oncologist didn't "brush me off" and neither should yours. 

Loretta

Peritoneal Carcinomatosis/Ovarian Cancer Stage IV

http://www.medicinenet.com/pleural_effusion_fluid_in_the_chest_or_on_lung/page3.htm

“Pleural  Effusion  (Fluid  In  the  Chest  or  On  the  Lung)

“…Chest X-ray can detect pleural effusions, as they usually appear as whitish areas at the lung base, and they may occur on only one side (unilateral) or on both sides (bilateral). If a person lies on their side for a few minutes, most pleural effusions will move and layer out along that side of the chest cavity which is positioned downward (because of the effects of gravity). This movement of the pleural effusion can be seen on an X-ray taken with the person lying on their side (a lateral decubitus X-ray).

Other imaging tests, such as CT scan, may be ordered to further identify the possible cause and the extent of the pleural effusion…

Small transudative pleural effusions may require no treatment, while larger ones and most exudative pleural effusions require treatment. The initial treatment of choice is drainage of the pleural fluid. This is done by thoracentesis (this procedure may be both diagnostic and therapeutic), where a tube is inserted into the effusion, and the effusion is drained out. This procedure needs monitoring, and in some instances, the tube may need to remain in the pleural space for a longer period of time for continued drainage. The need for repeated thoracentesis varies from patient to patient depending on the underlying cause, the amount of effusion fluid, the type of effusion (thick, thin, malignant, or infectious, for example) and if there is recurrence of the pleural effusion.

Some pleural effusions (mainly exudative) may require surgery to break up adhesions, while others may require pleurodesis (pleural sclerosis), a procedure whereby different irritant substances or medications are inserted into the pleural space in order to fibrose and scar the visceral and pleural surfaces together. This procedure seals the pleural space so that pleural effusions have difficulty reaccumulating…

The potential complications associated with pleural effusion are:

lung scarring, pneumothorax (collapse of the lung) as a complication of thoracentesis, empyema (a collection of pus within the pleural space), and sepsis (blood infection) sometimes leading to death…”

 

Jodisgoing180

He did say he was concerned

He did say he was concerned that draining it again may cause a collapse. I have had it X-rated and it is small.