Pleural Effusion

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Hi, so I have a family member who has been suffering with a pleural effusion since May of this year. She had a drain inserted a couple of months ago and has been having the fluid drained at home. The fluid itself looked like a pint of bitter - dark yellow/brown colour with a 'head' which was cream coloured. My family member has had a CT scan amongst other things, and when she saw a consultant last, he stated that the effusion was caused by a massive infection.

I believe that the family members she went to the hospital with weren't particularly asking the right questions. It seems they asked about lung nodules and were they a sign the lung cancer she suffers with has spread. The consultant said he could see no sign of a spread of cancer but had to wait for a final report.

The last CT scan she had was a couple of weeks before this appointment. She has lost a HUGE amount of weight (perhaps three stone in the last couple of months?). She is skeletal, sleeps a LOT, is bad tempered, and doesn't have the energy to do even half of the things she used to.

Now, she is having the drain removed on Tuesday because apparently there is no more fluid coming from the effusion. The consultant has advised that she needs to start eating more lean protein and lay off the cakes and biscuits (she eats LOADS of sweet things!).

I have spoken to an ex-EOL cancer nurse and she has said it sounds like the beginning of the end stages of cancer, but I am not getting any straight answers from other family members. They are in-laws btw, not directly related. I'm trying to make sure my husband is as well informed as possible due to issues he has from the past, but I just don't know what this all means!

Does this sound like my family member is going to make a full recovery or does it seem like the lung cancer has spread and the prognosis isn't as good as the rest of the family think it is? The consultant did say he needed to wait for a 'final' (??) report, presumably from the CT scan but did say he couldn't see nodules which the family have picked up on as being a positive thing and that the cancer can't possibly have spread if there are no lung nodules.

The outside symptoms we can see are;

Huge weight loss
Being bad tempered
Being forgetful
Excessive sleeping/falling asleep anywhere
Unable to do things like cooking meals for herself/others
Being breathless (but not as bad as when she was admitted to hospital to have the fluid drained)
Unable to walk long distances (waiting to be fitted for a wheelchair)
Told to eat a lot of lean protein

TIA

Helen M - Macmillan over 1 year ago

Hello Larkspur,

Thanks for getting in touch. My name is Helen, I’m one of the Cancer Information Nurses on the Macmillan Support Line.

Welcome to the online community.

I can see how anxious you are to understand your husband’s relative’s situation, and while we would want to be as helpful to you as we can, it is not possible to give an opinion on whether his relative will recover from her lung cancer or not.

In part this is because we on the support line, don’t have access to patients’ clinical details (such as the type of lung cancer or the stage), which allows us to understand the medical context of a query. And also because we are unable to undertake any kind of meaningful assessment.

I hope you understand.

A pleural effusion, or fluid on the lungs, is commonly caused by an infection, but can sometimes be caused by cancer, which is sometimes called a malignant plural effusion.

You mention your relative’s consultant has said her effusion has been due to a serious infection.

You also understand her consultant has said that early indications from her CT scan have not shown any spread of the lung cancer and that he was waiting for the final report, this will be from the consultant radiologist, to confirm this.

A CT scan can show evidence of lymph node involvement, which is one of the indicators of a cancer moving from its original, or primary, site. I think the word nodule might perhaps refer to the lymph nodes.

She is clearly not feeling well but whether it is due to the prolonged pleural effusion and the chest drain or not, again is very hard for us to comment on. Certainly her medical issues will have an impact on her mood, her energy levels, her appetite and weight. I hope the links can provide some useful information.

In addition, your husband might be able to share our booklet The Building Up Diet with his relative, which has plenty of helpful advice, along with our information on managing breathlessness. All our booklets can be ordered as hard copies here.

You might consider speaking to one of our nurses – it’s often so much easier to explore circumstances together over the phone.

I hope this information is useful. Please don’t hesitate to get back in contact by email, webchat or phone, if you need further information or support.

The Macmillan Support Line offers practical, clinical, financial and emotional support. You can call us free from landlines and from most mobile phone networks on 0808 808 00 00, 7 days a week, 8am – 8pm.

Best wishes, Helen

Cancer Information Nurse Specialist

Ref HM/JF

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Pleural Effusion