Find Information About:

Drugs & Supplements

Get information and reviews on prescription drugs, over-the-counter medications, vitamins, and supplements. Search by name or medical condition.

Pill Identifier

Pill Identifier

Having trouble identifying your pills?

Enter the shape, color, or imprint of your prescription or OTC drug. Our pill identification tool will display pictures that you can compare to your pill.

Get Started

My Medicine

Save your medicine, check interactions, sign up for FDA alerts, create family profiles and more.

Get Started

WebMD Health Experts and Community

Talk to health experts and other people like you in WebMD's Communities. It's a safe forum where you can create or participate in support groups and discussions about health topics that interest you.

  • Second Opinion

    Second Opinion

    Read expert perspectives on popular health topics.

  • Community


    Connect with people like you, and get expert guidance on living a healthy life.

Got a health question? Get answers provided by leading organizations, doctors, and experts.

Get Answers

Sign up to receive WebMD's award-winning content delivered to your inbox.

Sign Up

Cancer Health Center

Font Size

Malignant Pleural Effusion


    Management of Malignant Pleural Effusions

    To treat or not to treat

    Pleural effusions are generally markers of advanced, unresectable disease or disease progression. The median survival for patients with malignant pleural effusions is around 3 to 4 months.[4,5] Because a paramalignant effusion resulting from pneumonia or atelectasis may be present, the cytology should be confirmed before major treatment decisions are made. Once the cytology has been confirmed, the management strategy depends on the underlying primary malignancy and the number and type of previous therapies. For example, patients with newly diagnosed small cell carcinoma or malignant lymphoma are very likely to respond to systemic chemotherapy; however, patients who have already failed several lines of chemotherapy for gastric or ovarian cancer are unlikely to obtain significant palliation with systemic therapy.

    About three-quarters of patients exhibit symptoms such as cough, dyspnea, and chest discomfort. Such patients may benefit from efforts to reduce the fluid burden, depending on their performance status, expected survival, and preference for risks versus benefits. The literature on the efficacy of treatment for pleural effusions is difficult to interpret because of the paucity of randomized trials, and the wide variability in the response criteria and the timing and duration of follow-up in uncontrolled trials.[6,7] Generally, the goal of therapy is palliation of symptoms. Measures of success may include complete drainage of the effusion, lung re-expansion, lack of fluid reaccumulation (i.e., duration of response), and subjective report of symptom relief. The choice of treatment depends on patient prognosis, functional status, and goals of care.


    Thoracentesis involves percutaneous insertion of a needle for drainage of the effusion. Thoracentesis is not expected to permanently resolve the problem but rather to alleviate symptoms that are acute and severe. The use of thoracentesis is also appropriate as a therapeutic trial to determine whether fluid drainage is beneficial when the relationship between symptoms and effusion is unclear.

    Most effusions will reaccumulate a few days after thoracentesis. The reaccumulation rate is approximately 98% by day 30.[8] Repeated thoracenteses carry the potential risks of bleeding, infection, and pneumothorax. Other potential complications of thoracentesis include noncardiogenic pulmonary edema from rapid lung re-expansion (usually with the rapid removal of >1,500 cc) and pleural shock caused by an excessive vagal response to penetration of the parietal pleura. Any of these complications may be lethal, especially for the cancer patient with poor cardiopulmonary reserve.


    Today on WebMD

    Colorectal cancer cells
    New! I AM Not Cancer Facebook Group
    Lung cancer xray
    See it in pictures, plus read the facts.
    sauteed cherry tomatoes
    Fight cancer one plate at a time.
    Ovarian cancer illustration
    Real Cancer Perspectives
    Jennifer Goodman Linn self-portrait
    what is your cancer risk
    colorectal cancer treatment advances
    breast cancer overview slideshow
    prostate cancer overview
    lung cancer overview slideshow
    ovarian cancer overview slideshow
    Actor Michael Douglas