Complications Of Lung Cancer
Lung cancer can lead to complications. These include:
- High risk of infection: People with lung cancer are at an increased risk of pneumonia, bronchitis, and other infections.
- Facial swelling: Tumors in your lungs can restrict blood flow to your upper body and result in facial swelling.
- Loss of lung function: Shortness of breath, difficulty breathing, and other symptoms of reduced lung function can occur in lung cancer patients.
- Blood clots: People with lung cancer are at a higher risk of clots, especially in their lower legs.
- Spitting up blood: Irritation in airways or from tumors can result in spitting up blood.
- Increased calcium in blood: Sometimes, lung cancer can result in hypercalcemia, or increased calcium in your blood.
- Spinal compression: Tumors can press on the spine and cause pain, weakness, and trouble walking.
- Heart blockage: Tumors in your lungs can compress heart vessels and lead to multiple serious heart conditions.
- Nerve pain: Tumors can result in nerve pain along with numbness, tingling, and weakness.
- Trouble swallowing: Lung cancer can spread to your esophagus and cause trouble swallowing.
What Causes A Pleural Effusion
There are several different causes of pleural effusion. For people with cancer, pleural effusions are often malignant . This means that there are cancer cells in the pleural space causing fluid to build up. Sometimes, a pleural effusion can occur as a result of inflammation, lung obstruction, trauma, or another medical condition that may not be due to cancer.
Certain types of cancer. Some types of cancer are more likely to cause a pleural effusion. For example, around 40% of people with lung cancer develop a pleural effusion at some point during the course of their cancer.
Thoracentesis, a needle removes fluid from the pleural space for testing
After the fluid is removed for testing, a pathologist will confirm if the effusion is malignant or not, meaning if there are cancer cells present in the fluid or not. This is called pleural fluid cytology. A pathologist is a doctor who specializes in interpreting laboratory tests and evaluating cells, tissues, and organs to diagnose disease.
Tips For Lung Cancer Prevention
There is no guaranteed way to prevent lung cancer. However, you can reduce your risk if you:
- Quit smoking: Smoking is the number-one risk factor for lung cancer. Eliminating smoking greatly reduces your chance of developing lung cancer.
- Avoid radon: You can have your home tested for radon to help reduce your exposure and lung cancer risk.
- Avoid other cancer-causing chemicals: Limiting your exposure to other cancer-causing chemicals can reduce your risk.
- Eat a healthy diet: There is some
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Rarely Used And Historical Agents:
Doxycycline is analogous to tetracycline. In a few number of studies, pleurodesis results with doxycycline are evaluated. The success rate was estimated as 76% . The side effects from doxycycline treatment are similar to those from tetracycline treatment, which includes pleurotic chest pain and fever . One major disadvantage of doxycyline therapy is the need for repeated treatment practice to reach success. This situation may cause a long duration of catheter or intercostal tube insertion, increasing the risk of infection, patient discomfort and cost.
Monocycline was used as a sclerosant agent. However, limited numbers of studies have reported the effects in humans . One study done with rabbits has shown that it can be as effective in pleurodesis as tetracycline .
Corynebacterium parvum extract, interferons, interleukins and several chemotherapeutic drugs are agents used for pleurodesis. Most studies are uncontrolled and have small numbers of patients. Corynebacterium parvum, interferons and interleukins require multiple administrations, while significant toxicity is encountered with the use of the chemotherapeutic drugs .
How Is A Malignant Pleural Effusion Treated
The most common treatment is to drain the malignant pleural fluid. Chemotherapy can also prevent the effusion from returning.
Treatment for a pleural effusion can be given in a hospital or an outpatient setting. There are several methods available to remove fluid. You and your health care team will discuss the best treatment options for you.
Thoracentesis. This procedure removes the fluid from around the lungs. It can also be used to diagnose a pleural effusion. During thoracentesis, a doctor inserts a needle to remove the fluid. An ultrasound probe may be used before a thoracentesis to see if there is enough fluid to drain.
Tube thoracostomy. In this procedure, a doctor inserts a tube into your chest to drain the fluid. Typically, the chest tube stays in for a day or longer until enough of the fluid has drained. Then, a chemical is used to stick the edge of the lung to the chest wall. This treatment, called pleurodesis, decreases the chance that the fluid will return.
Catheter. Sometimes, a catheter is used to drain fluid. A catheter is a thin tube of plastic that is inserted into the pleural fluid. A tunneled pleural catheter can also be used. This type of catheter can be left in for long periods of time for ongoing draining. At home, you or your family member use the catheter to drain the fluid into a bottle as instructed by your doctor. After time, if your body does not produce anymore pleural effusion fluid, the catheter can be removed.
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Treatments For Pleural Effusion
There are several treatment options for pleural effusions, including draining the excess fluid and medications to help the body get rid of water. In some cases, the treatments may only be needed once, and in others, they are repeated to help keep fluid out of the lungs.
- Medications such as diuretics
Read more about these treatments below.
Fluid Buildup On The Lungs
Fluid buildup on the lungs is called pleural effusion. It’s when too much fluid builds up in the pleural cavity, which is the space between the lungs and the chest wall. The pleural cavity is surrounded by 2 thin layers of tissue called the pleura that cover the lungs and line the chest wall. Normally there is a small amount of fluid between the layers of the pleura that keeps the tissues moist and helps the lungs breathe without any friction. The fluid is made by cells in the pleura, and it is constantly drained through the lymphatic system and replaced again.
If pleural effusion is a side effect of cancer or there are cancer cells in the fluid, it may be called malignant pleural effusion.
Pleural effusion can be in just one lung or in both lungs.
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How You Have Pleurodesis
There are different ways of having this treatment, depending on whether you need to have fluid drained beforehand.
If you have no fluid to be drained, your doctor might put a thorascope into your chest until it is between the coverings of the lung . The doctor can see through the tube so they know exactly where to put the sterile powder. They can put the powder in through the thorascope tube. This way of doing pleurodesis is called video assisted thoracoscopy.
If you need to have fluid drained from between the pleura beforehand, your doctor will first give you a small injection of local anaesthetic. When the anaesthetic has worked, the doctor puts a wide needle into your chest, ususally through your side.
The tip of the needle goes into the pleural space, where the fluid is collecting. Once it is in the right place, the doctor attaches the needle to a drainage tube called a chest drain, which in turn is attached to a collecting bottle or bag. Your doctor puts a stitch around the tube to hold it in place. This is called a purse string suture.
As long as the drainage bottle or bag is kept lower than your chest, the fluid drains out automatically. If there is a lot of fluid, this can take several hours.
It has to be done slowly, because draining a large amount of fluid too quickly can make your blood pressure drop suddenly making you feel faint. Also the lung expanding too quickly can make you more breathless.
How Is Fluid Around The Lung Diagnosed
A physician will usually diagnosis pleural effusion based on interviewing the patient about symptoms and a physical examination. To confirm a diagnosis, he or she may also request an imaging test, which could be a chest X-ray, ultrasound, or computed tomography scan. To further help with diagnosis, a doctor may extract a sample of the excess fluid to be tested to determine the cause.
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Risk Factors For Lung Cancer
There are multiple known risk factors for lung cancer. These include:
- Smoking: Smoking is the single biggest risk factor for lung cancer. This includes cigarettes, cigars, and pipes. Tobacco products contain thousands of toxic substances. According to the
9 out of 10 lung cancers. Plus, you dont have to be a smoker to be affected. Secondhand smoke also increases your risk of lung cancer.
In addition to cigarettes, cigar and pipe smoking are also linked to lung cancer. The more you smoke and the longer you smoke, the greater your chance of developing lung cancer.
Former smokers are still at risk of developing lung cancer, but quitting can lower that risk considerably. Within 10 years of quitting smoking, the risk of dying from lung cancer drops by half.
Lung Cancer: Fluid Around Lungs
One of the complications of lung cancer is the accumulation of fluid around lungs, which is known as pleural effusion. It often results due to spreading of the cancer cells outside the lungs.
Did you know?Before going to any other organ in the body, the blood goes to the lungs, due to which the cancer cells in the bloodstream tend to get stuck in the lungs tiny capillaries. This makes lungs the most common organ to which cancers spread.
Our lungs play a very important role in supplying oxygen to the bloodstream. Even when the blood flows back from the entire body to the heart, the lungs are the first ones to receive the blood from the heart, before any other organ. Unfortunately, this mechanism makes them more vulnerable to cancer cells, which may affect the lungs and its surrounding tissues, including the pleura.
As you can see in the diagram above, the pleura are the protective tissue sheets of the lungs, also referred as the lung lining. They contain a gap between them which is called the pleural space. In order to keep the pleura moistened, they produce lubricating fluids to enable them to move smoothly with the lungs during the breathing process. However, when cancer cells reach the pleura, they cause a reaction which enables these membranes to produce excessive amount of fluid between the pleural space. Hence, this condition is called pleural effusion.
- Shortness of breath
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Choosing The Appropriate Treatment
There has been debate over whether pleurodesis or an indwelling pleural catheter is the better option for people with advanced cancer and a recurrent pleural effusion.
A 2017 study published in the Journal of the American Medical Association, sought to answer this question. The researchers found that those who had indwelling pleural catheters had fewer hospitalizations than those who had pleurodesis, primarily related to the need for procedures to remove pleural fluid.
Otherwise, there were no significant differences in either the sensation of shortness of breath or the quality of life of participants.
Before a pleurodesis or tunneled pleural catheter is recommended, a few things are necessary:
- First, your doctor will want to confirm that you have a malignant pleural effusion and that your symptoms are not due to another cause.
- Secondly, you should have a pleural effusion that recurs after a thoracentesis.
- Thirdly and most importantly, the draining of the fluid from your pleural space should help with your symptoms of shortness of breath.
It is not necessary to remove fluid just because it is there, but only if it is causing problems such as shortness of breath. If the shortness of breath is due to another cause, such as COPD, there is usually no benefit to removing the fluid.
What Are The Symptoms Of Pleural Effusion
The symptoms of pleural effusion can range from none to shortness of breath to coughing, among others. The greater the build-up of fluid, the more likely symptoms will be noticeable.
In addition to excess fluid, the tissue around the lung may become inflamed, which can cause chest pain. In extreme cases, a person can have up to four liters of excess fluid in the chest. It’s very uncomfortable. Imagine trying to breathe with two soda bottles pushed up against your lungs, Dr. Puchalski says.
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Pulmonary Edema Vs Pneumonia
Pneumonia is another serious condition of the lungs. Unlike edema, pneumonia is caused by viral, fungal, or bacterial infection. As your lungs become infected, fluid builds up in the air sacs .
While pulmonary edema and pneumonia cause buildup in the lungs, the former is primarily caused by CHF. Pneumonia, on the other hand, is caused by an infection. A weakened immune system can increase your chances of getting pneumonia from a common cold or flu.
Symptoms of pneumonia may include:
- high fever with chills
Formation Of Mpe: General Aspects
Pleural fluid accumulates when its production overwhelms removal. The reason why some tumours cause effusions while others do not is unclear. Post mortem studies demonstrate that mediastinal lymph node invasion, but not the extent of pleural involvement, predicts the presence of an effusion . In addition, it has long been believed that pleural fluid clearance occurs through the lymphatics that originate from the stomata of the parietal pleura and drains through the mediastinal nodes. Based on the above, it was initially assumed that impaired pleural fluid drainage, secondary to tumour invasion of the drainage system, is the primary mechanism of MPE formation. However, this notion was challenged by the following: 1) the rate of MPE accumulation is commonly higher than that expected if it is merely due to clearance of the fluid occurring secondary to lymphatic blockage 2) in the majority of MPE, the protein content is higher than that in normal pleural fluid, suggesting the presence of plasma leakage and 3) MPE occurs even in patients without parietal pleura involvement. It is therefore currently believed that a combination of increased fluid production due to fluid extravasation from hyper-permeable parietal or visceral pleural and/or tumour vessels and impaired lymphatic outflow underlie the development of MPE .
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Draining A Pleural Effusion At Home
If fluid keeps building up, it is possible to have repeated chest drains put in. However, this can be uncomfortable and may mean making a number of trips to the hospital.
It may be possible for you to have a special catheter put in, called a tunnelled indwelling pleural catheter . This is so you can have your pleural effusion drained easily while you are at home. When you have a build up of fluid on the lung, the TIPC allows you to drain the fluid into a bottle. This can be done by you, a family member or a nurse.
The catheter is inserted in hospital on a day ward. As long as there are no complications, you can usually go home on the same day.
Your doctor or specialist nurse will explain more about this method and tell you if its suitable for you.
Pulmonary Edema Vs Pleural Effusion
Pulmonary edema is sometimes confused with pleural effusion, another condition involving fluid buildup in the lungs. However, pleural effusion causes a buildup of fluids in the pleural tissues. These cover the outside of each of your lungs as well as the inside of the chest wall.
Causes of pleural effusion may
With pleural effusion, you may experience:
- breathing difficulties
- shortness of breath
- chest pain and discomfort
A chest X-ray can help diagnose pleural effusion. A doctor may take a biopsy from pleural tissues if they suspect cancer. Depending on the cause, pleural effusion may be treated with a combination of fluid removal techniques and surgery.
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What Causes Pleural Effusion
Pleural effusions are very common, with approximately 100,000 cases diagnosed in the United States each year, according to the National Cancer Institute.
Depending on the cause, the excess fluid may be either protein-poor or protein-rich . These two categories help physicians determine the cause of the pleural effusion.
The most common causes of transudative pleural effusions include:
- Pleural fluid analysis
When the pleural effusion has remained undiagnosed despite previous, less-invasive tests, thoracoscopy may be performed. Thoracoscopy is a minimally invasive technique, also known as video-assisted thoracoscopic surgery, or VATS, performed under general anesthesia that allows for a visual evaluation of the pleura). Often, treatment of the effusion is combined with diagnosis in these cases.
Diet Recommendations For People With Lung Cancer
Theres no diet that can minimize lung cancer. However, its important to get all the nutrients your body needs.
Cancer treatments can cause you to lose your appetite. They can also make it hard for your body to absorb vitamins. If youre deficient in certain nutrients, your doctor can advise you on foods or supplements if needed.
Here are a few dietary tips:
- Eat whenever you have an appetite.
- If you dont have an appetite, try eating smaller meals throughout the day.
- If you need to gain weight, supplement with low-sugar, high-calorie foods and drinks.
- Use mint and ginger teas to soothe your digestive system.
- If your stomach is easily upset or you have mouth sores, avoid spicy food.
- If constipation is a problem, add more high-fiber foods.
As you progress through treatment, your tolerance to certain foods may change. So can your side effects and nutritional needs. Its worth discussing nutrition with your doctor. You can also ask for a referral to a nutritionist or dietician.
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