Mesothelioma and Pleural Effusions

Pleural effusions occur when fluid build ups in the pleura, which is the space between the chest wall and lungs.

Though a malignant pleural effusion diagnosis is treatable, it is a sign of pulmonary cancer, such as lung cancer or mesothelioma. 

Pleural Effusions

A pleural effusion is when fluid builds up between the lung and chest wall. In healthy people, a small amount of fluid fills this cavity, allowing the lungs to smoothly glide within the chest with every breath.

Excess fluid results in pleural effusion and can hinder one’s ability to breathe. 

The more fluid that fills up in the pleura the less space the lungs have to expand. As a result, pleural effusions compress the lungs and reduce their ability to move. This will cause breathing to feel painful and difficult. When the lung is compressed, it will be referred to as a nonexpandable lung. 

Pleural effusions on their own are not life threatening. In fact, pleural effusions without mesothelioma often resolve on their own within a few months. Once you have one pleural effusion, however, the condition is likely to be a repetitive issue. Pleural effusions can also be a sign of a life threatening illness, like mesothelioma. 

Commonality in Mesothelioma Patients 

Pleural effusions are typically a sign of an asbestos-related disease. Mesothelioma or pleural thickening are two examples. The effusions will contribute to the disease’s progression. According to a study conducted in 2019, 83% of patients with mesothelioma had a pleural effusion. 33% of these participants also had nonexpandable lung. 

Symptoms 

Symptoms and severity will vary from person to person. Cough and breathlessness are the most common symptoms for those with non-expandable lungs. Mesothelioma patients without effusions are more likely to experience chest pain.

Below is a list of common symptoms associated with pleural effusions:

• Dry cough
• Fatigue 
• Fever (after infection)
• Hiccups 
• Malaise 
• Rapid and shallow breathing 
• Sharp chest pain
• Shortness of breath 

Cause 

Many causes can lead to pleural effusions, but asbestos exposure and asbestos-related illnesses are the most common causes. Mesothelioma, asbestosis, and lung cancer often are accompanied by pleural effusions. 

If you are exposed to asbestos, the sharp asbestos fibers can lodge into the lungs and reach the pleura. This results in swelling and inflammation. These side effects often cause blood vessels to leak fluids, resulting in pleural effusions. 

Pleural effusions can also be nonmalignant, meaning not cancerous. Pneumonia, tuberculosis, and congestive heart failure are all nonmalignant causes of pleural effusions. 

Diagnosis 

Pleural effusions can be diagnosed in several ways. If there are more than 300 milliliters of fluid accumulation, X-Rays will be able to demonstrate the fluid. Doctors will also look for other signs, such as decreased chest movement or diminished breath sounds. 

After doctors have confirmed that there is fluid buildup, they will determine the cause. A diagnostic thoracentesis will remove fluid so that it can be tested. 

Treatment 

Pleural effusions are typically easy to treat. Palliative thoracentesis, catheter placement, pleurodesis, video assisted thoracoscopic surgery, and shunt placement are all viable options.