Lung cancer, like all cancers, results in the abnormality of growth in the basic unit of life, the cell. Under normal circumstances the growth of a cell divides to produce new cells only when it is needed. When this system of checks and balances of the growth of a cell results in an uncontrolled division of cells, a mass or tumor is the result.
Tumors are designated benign or malignant. This means that they either will spread and metastasize to other parts of the body or will remain as a local growth. When referring to cancer, it is a malignant growth to which we refer. This means that malignant tumors will grow aggressively and invade other tissues of the body. The process of spreading of the tumor is called metastasis. The most common areas for lung cancer to metastasize are the adrenal glands, the liver, the brain and bone.
The lung is also a very common site for metastasis from other tumors in other parts of the body. If this should occur the classification of the metastatic tumor would be that of your primary tumor. This means that if the primary tumor first grew in the prostate gland, any tumor in the lung would be referred to as a metastatic growth of prostate cancer.
In either case, tumor growth in the lungs can result in a plural effusion. The lungs are lined with cells called the pleura. This pleura has an inner layer and an outer layer. The pleura produces a fluid that acts as a lubricant and allows an individual to breathe easier without the lungs rubbing up against muscle. Sometimes too much of the fluid can build up between the two layers of the pleura. This is called a plural effusion.
Tumor growth in the lungs, when located near the exterior of the organ, can cause a plural effusion which requires immediate medical care. A plural effusion can also be caused by infections such as pneumonia or heart failure. It occurs also in lung cancer when the cancer cells have spread into the plural membrane cause fluid to build up.
Treatment of a plural effusion is done in the hospital. The goal of treatment is to remove the buildup of fluid and to relieve the symptoms. A drain is placed in the hospital, into the chest wall, by a physician who uses ultrasound to help place the drain in the correct position. The individual is asked to either sit and lean forward to more easily expose the back.
The area will be an anesthetized by the physician and then a very small cut into the chest will be made where the physician will place a needle. This needle is attached to a tube and drainage bag or bottle where the fluid will drain out of the chest and collect inside the bag. This needle, or cannula, is not a hard metal piece but rather a hard plastic.
The individual will usually need to stay in the hospital for several days as the fluid drains and the lungs heal. If there is a small amount of fluid the cannula will be removed immediately after the fluid is drained off and the area will be covered with a sterile dressing.
By draining the fluid from a plural space this will allow the lungs to re-expand and will ease the ability to breathe for the individual. In the case of individuals who have chronic plural effusion it may be possible to have this procedure done at home. The physician will place a tube in the hospital which is then clamped and covered with a dressing. On an intermittent basis a home care nurse can reattach a suction bottle to the catheter and drain off more fluid at home.
Once the lung re-inflates and the fluid has been drained, it may be possible to seal the two layers of pleura together to prevent fluid from building op once again. This procedure is known as a pleurodesis. During this process specific medications are used, and injected through the drain, to scar the pleura. During the procedure you will be asked to move around in bed to help the drugs circulate around the lining of the lungs. Afterwards the drain maybe reattach to a suction machine to apply a small amount of suction which encourages the pleura to become sealed together.
Treatment of a pleural effusion should be done by a physician or other healthcare professional in the hospital. If you believe that you may have a pleural effusion then you must seek the advice of your doctor immediately.
RESOURCES
Cleveland Clinic: Pleural Effusion
Robert Wood Johnson University Hospital: Malignant Pleural Effusions
Thoracic Interventions: Management of Pleural Effusion, Empyema and Lung Abscess
British Medical Bulletin: Pleural Effusion
UCLA Health System: Patient Education: Lung Cancer
MacMillan Cancer Support: Secondary Cancer in Lung Cancer
National Cancer Institute: Non-Small Cell Lung Cancer Treatment