MALIGNANT PLEURAL EFFUSIONS

Abstract

Pleural effusions are a common complication of advanced malignancies, and cause dyspnea, chest pain and cough. In most cases they signify incurable disease, with a median survival after diagnosis usually measured in months rather than years. Thus treatment focuses on improving patient symptoms rather than cure. Chest tube insertion and sclerotherapy, i.e. pleurodesis, remains the standard of care in most countries, with the goal of preventing fluid recurrence after removal. However newer therapeutic options, such as pleuroscopy and long-term indwelling pleuralcatheters, can be performed as outpatients or with a minimal hospital stay, may cause less discomfort to the patient than a standard chest tube or video assisted thorascopic surgery (VATS) pleurodesis, are cost effective, and may allow patients to spend more time away from the hospital with loved ones.