Pleural effusions are one of the symptoms of mesothelioma, an aggressive but rare type of cancer. Mesothelioma can develop in pleura, the lining of the lungs, which is known as pleural mesothelioma and accounts for about 70% of all cases. About 20% of the cases occur in the lining of the abdomen and it named pericardial mesothelioma, while pericardial mesothelioma refers to the disease in the lining of the heart and testicular mesothelioma occurs in the tunica vaginalis testis.

Mesothelioma is caused by exposure to asbestos, a natural mineral that may be woven and mixed into cement. After 100 years being used in industries like construction, shipbuilding and manufacturing, it was proven to be toxic, since asbestos fibers can be released into the air. These fibers can be swallowed or inhaled, and the body cannot properly expel them. As asbestos fibers become trapped in the body, the mesothelial cells are irritated, causing the formation of tumors.

How Pleural Effusions Affect Patients with Mesothelioma

The pleura is the lining that covers the lungs, and while pleural effusions are more common among patients with pleural mesothelioma, they can occur in patients who suffer from any form of the disease. Pleural effusions are a large amount of fluid that accumulate between the lungs and the chest cavity. In healthy patients, a small amount of lubricating fluid is present in the pleura, pericardium and peritoneum. The fluid keeps the organs moist and when its exceeds its normal level, about a couple of teaspoons, it is naturally expelled.

However, in patients with mesothelioma, the fluid may not be properly evacuated and it accumulates in the mesothelium.

Management of Pleural Effusions in Mesothelioma Patients

The best course of treatment to address the symptoms of mesothelioma is to treat the disease itself. There is no cure for this type of cancer, but chemotherapy and radiation therapy are possibilities to either shrink the tumor or kill cancer cells. Chemotherapy and radiation can be administered alone or in combination with surgery to resect the tumors. Specifically for pleural effusions, there are procedures to collect the fluid. The least invasive procedure is to use a needle to drain the fluid and reduce the pleural effusions. The procedure is known as thorancentesis, but it is also the oldest and least common surgical procedure. A pleurodesis is also an option and it usually has better results.

A more invasive surgical intervention may be necessary when it is not possible to drain the fluid. During the pleurodesis, the surgeon makes a small incision to enter a small camera to increase visibility and remove the fluid. If left untreated, pleural effusion can cause the collapse of the lung or atelectasis since the organ cannot fully expand and normally breath. These procedures are expected to improve symptoms associated with pleural effusions, which include shortness of breath, chest or abdominal pain, fatigue or rapid heartbeat. Some patients may also feel like they are suffocating or drowning, and develop a pneumonia or other lung diseases.
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