Fluid Around the Lungs or Malignant Pleural Effusion

Approved by the Cancer.Net Editorial Board, 09/2019

A pleural effusion is a buildup of extra fluid in the space between the lungs and the chest wall. This area is called the pleural space. About half of people with cancer develop a pleural effusion.

When cancer grows in the pleural space, it causes a malignant pleural effusion. This condition is a sign that the cancer has spread, or metastasized, to other areas of the body. Common causes of malignant pleural effusion are lymphoma and cancers of the breast, lung, and ovary. A malignant pleural effusion is treatable. But it can be a serious and potentially life-threatening condition.

Symptoms of a pleural effusion

Relieving side effects is an important part of cancer care and treatment. This is called palliative care or supportive care. Talk with your health care team about any symptoms you experience and any changes in symptoms.

People with a pleural effusion may experience the following symptoms:

  • Shortness of breath

  • Dry cough

  • Pain

  • Feeling of chest heaviness or tightness

  • Inability to lie flat

  • Inability to exercise

  • Generally feeling unwell

Diagnosing pleural effusion

Your doctor may use the following tests to locate, diagnose, or plan treatment for a malignant pleural effusion:

  • Physical examination

  • Chest x-ray, which is a picture of the inside of the body showing fluid buildup

  • Computed tomography (CT) scan, which creates a 3-dimensional picture of the inside of the body

  • Ultrasound, which uses sound waves to create a picture of the inside of the body

  • Thoracentesis, which is using a needle to remove fluid from the pleural space for testing

Treating pleural effusion

A pleural effusion often needs to be treated in a hospital or clinic. The most common treatment is to drain the malignant pleural fluid. This may be done in several ways:

  • Thoracentesis (see above)

  • Tube thoracostomy, which uses a tube inserted into the chest for 24 hours to drain the fluid. This is usually followed by a process called pleurodesis. This process uses substances, such as talc, to stick the edge of the lung to the chest wall. This decreases the chance that the fluid will return.

  • Temporary insertion of a catheter into the pleural space. You or your family member use the catheter to drain the fluid into a bottle as instructed by your doctor.

  • Insertion of a shunt, which bypasses or diverts excess fluid from 1 place to another

  • Treating the cancer with chemotherapy to prevent the effusion from returning

Related Resources

Getting Started With Palliative Care