People who have pleural mesothelioma, a cancer of the lungs caused by exposure to asbestos, often develop pleural effusions. This essentially means that they develop fluid on the lungs. An effusion is a medical emergency, particularly in people with mesothelioma and will need to be treated as soon as possible.

What Is Mesothelioma?

Mesothelioma develops as a result of prolonged exposure to asbestos, although it remains unclear how long someone had to be exposed, and to what levels. Many people who develop mesothelioma first developed asbestosis.

Mesothelioma and Fluid on Lungs

Pleural effusions in mesothelioma patients is a severe, often lethal condition. Unfortunately, it is very common for patients to develop effusions, due to the fact that their lungs no longer function normally. Furthermore, developing a pleural effusion is often evidence of the disease becoming worse. At the same time, because the lungs in mesothelioma patients are weakened, there is a possibility that the effusion is caused by a secondary lung disease, such as bronchitis or pneumonia.

In a patient with mesothelioma, the effusion usually affects the pericardium or the pleura. Fluid starts to build up between the chest cavity and the lungs. If the effusion is pericardial, the fluid collects in the sac that surrounds the heart. A small amount of fluid is found there anyway to lubricate the area, but there is a significant buildup in people who have an effusion.

Once an effusion develops and fluids start to collect and be retained, the organ that they surround can no longer function in the way it should. Since someone with mesothelioma already has decreased organ function, this presents a very dangerous situation. With a pleural effusion, the pressure on the lungs becomes extreme and patients develop shortness of breath, wheezing, and other symptoms of having difficulty in breathing. The condition is caused by the lung becoming inflamed as a result of the tumor growth, which is known as an exudate effusion. In rare cases, a transudate effusion happens, which is caused by distressed blood vessels leaking. A lot of patients with mesothelioma develop both exudate and transudate effusions are found, particularly once the cancer reaches stage 4.

Once someone has a pleural effusion, they are at risk of developing secondary conditions, including:

• Atelectasis, which means the lung cannot expand properly anymore, making it more difficult to breathe. In severe cases, the lung completely collapses.
• Pneumonia
• Other lung disorders

Symptoms of Pleural Effusion

Someone with a pleural effusion will usually experience:

• Shortness of breath
• Wheezing
• Chest pain
• Rapid heartbeat
• Fatigue
• A drowning sensation

Treatment for Pleural Effusion

Most effusions in people with mesothelioma are treated through chemotherapy. If the effusion is incredibly severe, it may be drained to provide instant relief. To treat a mesothelioma pleural effusion, a physician will always first try to determine the actual cause of the presence of the fluid. In most cases, a transudate effusion can be treated by removing the fluid, which can be achieved through drains. The danger, however, is that this is an invasive procedure and since mesothelioma patients are already weakened, particularly in the lung area, this procedure may be too much for them to handle. However, in most cases, there is no need for an intercostal chest drain, and a thoracentesis is sufficient. The fluid that is removed will usually be collected for testing to determine whether a certain type of infection is causing the effusion.

Interestingly, a lot of mesothelioma cases have been diagnosed due to pleural effusions. Because mesothelioma is often asymptomatic until it is in advanced stages, and because the cancer has a very long latency period (between 10 and 60 years), it is not uncommon for people to simply not know that they have it. Once they start experiencing shortness of breath and pain in the chest area, which are caused by pleural effusions, tests may reveal that they actually also have mesothelioma and the effusion was caused by it.

At the same time, performing a cytological examination, which means that the fluid is tested, can provide equivocal results. This is because it is not often clear that mesothelioma is actuallly present. This is one of the reasons why a physician will inquire with regards to the patients’ past lifestyle and whether or not they have had any asbestos exposure. To confirm whether or not mesothelioma is present, further tests, such as the CT scan and the PET test have to be performed.

Unfortunately, because mesothelioma is so rare, many tests will have to take place in order to confirm its presence. Some of the tests are surgical in nature, and this gives physicians the chance to also address any fluid buildup on the lungs. If caught early enough, the chemotherapy provided in the treatment of mesothelioma will also help to address the pleural effusion at the same time.

Fluid on the Lungs Prognosis

Unfortunately, the presence of a pleural effusion is often a sign that the cancer has spread and is affecting more parts of the body. It is a very serious symptom and it can make all the other mesothelioma symptoms a lot worse. The prognosis for people with mesothelioma who develop a pleural effusion is, unfortunately, very poor. If the pleural effusion is discovered before the mesothelioma, prognosis is slightly better. The prognosis for mesothelioma is only around 18 months, however, and this is unchanged if the patient was initially diagnosed to have fluid on the lungs. If, however, the patient already has a mesothelioma diagnosis and then, later on, develops a pleural effusion, the remaining time will be significantly reduced.