Pleural Effusion and Asbestos

Pleural effusion, a buildup of fluid in the pleural cavity, is a typical complication of pleural mesothelioma and other asbestos-related diseases. Pleural effusion can be uncomfortable and limit mobility. Treatment includes draining the fluid from the chest cavity.

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What Is Pleural Effusion?

In medical terms, effusion refers to a buildup of fluid in the body. The pleura is a thin, double layer of tissue around the lungs. Pleural effusion is a buildup of fluid between the two layers of the pleura.

There are many causes of pleural effusion, affecting about 1.5 million people in the U.S. annually. Pleural effusion is painful and makes breathing difficult. Treatment includes addressing the underlying cause and treating the symptoms.

Can Asbestos Cause Pleural Effusion?

Many underlying conditions can cause fluid to collect in the pleural tissue. Asbestos exposure and asbestos illnesses can cause pleural effusion.

Asbestos fibers in lung and pleural tissue cause inflammation, which can trigger fluid buildup. This inflammation can cause blood vessels and other nearby tissue to leak fluid into the pleural space.

Mesothelioma, the cancer of the pleural tissue, can also cause pleural effusion. Pleural effusion related to asbestos can be either malignant or non-malignant.

Pleural Effusion Symptoms

Sometimes, people with pleural effusion exhibit only one to two symptoms, whereas another person may have multiple symptoms. The possible symptoms of pleural effusion include:

• Chest pain that increases when inhaling
• Dry, hacking cough
• A general feeling of uneasiness and discomfort
• Frequent hiccups
• Rapid, short breaths
• Orthopnea, the inability to breathe normally unless sitting upright

How Does Pleural Effusion Develop?

Mesothelioma or asbestosis, conditions resulting from asbestos exposure, are two causes of pleural effusion.

When someone inhales asbestos fibers, they reach the pleural lining of the lungs. While some fibers are excreted naturally from the body, it’s impossible to eliminate every asbestos fiber entering the body. Over time, the microscopic asbestos fibers cause pain, swelling, and inflammation.

What Are the Types and Causes of Pleural Effusion?

Pleural effusion can be transudative (a watery fluid buildup caused by pressure on organs) or exudative (protein fluid buildup caused by inflammation and infections). Aside from asbestos exposure, other common reasons that pleural effusion develops include:

Exudative:

• Pneumonia
• Kidney diseases
• Pulmonary diseases

Transudative:

• Open-heart surgery
• Pulmonary diseases
• Cirrhosis
• Heart failure

Sometimes, pleural effusion is caused by certain medications, radiation therapy, and stomach surgery.

Other causes, although rare, include tuberculosis, autoimmune diseases such as rheumatoid arthritis, and chest bleeding due to trauma.

What Type of Pleural Effusion Is Associated with Mesothelioma?

Mesothelioma is associated with exudative pleural effusion. The tumors in the pleural tissue and the resulting inflammation cause fluid to develop. This type of effusion also results from poor drainage of lymph nodes around the pleura.

Pleural Effusion Diagnosis

Pleural effusion is easy to detect. More complicated is a diagnosis for the underlying cause. Identifying pleural effusion early can help patients get a diagnosis of mesothelioma sooner. This improves treatment options and prognosis.

The starting point in diagnosing pleural effusion is usually X-ray imaging, which allows physicians to view the fluid accumulation in the pleura. Other ways of viewing the fluid buildup may include a CT scan or chest ultrasound.

A thoracoscopy is performed if there isn’t enough fluid for a proper diagnosis via imaging. A thoracoscopy is a procedure that involves inserting a thin tube, known as a thoracoscope, into the chest via a small incision.

The thoracoscope allows doctors to view the lungs, pleura, and surrounding areas more in-depth. In most cases, a sample of the fluid is taken to analyze it for cancer cells or bacterial infections. Pleural fluid may contain cancer cells or biomarkers to help diagnose mesothelioma.

Doctors will also look for physical signs when diagnosing, such as abnormal breathing sounds, reduced chest movement, and diminished vocal resonance.

Does Pleural Effusion Have to Be Treated?

Minor cases of pleural effusion may go away without treatment. These are cases that result from minor infection or inflammation. Pleural effusion related to asbestos and mesothelioma is usually chronic. It keeps returning and requires ongoing treatment.

How Do You Treat Pleural Effusion From Asbestos?

The type of treatment for pleural effusion depends on individual factors in each case and may include:

Medication

People with heart failure may require diuretics, heart medication, and, in severe cases, a combination of radiation therapy and chemotherapy.

Thoracentesis

For patients with a respiratory illness, the fluid is normally drained via therapeutic thoracentesis. This involves using a needle to draw fluid out of the pleural space.

Uncontrollable fluid buildup after drainage may require thoracentesis and a sclerosing-type drug, which helps to reduce and heal scarring.

Indwelling Catheter

For people with mesothelioma and other asbestos-related illnesses, there is a chance that, along with repeated thoracentesis treatments, patients may need a catheter if the fluid fails to drain on its own or returns continuously.

The catheter is a small tube inserted into the pleural space. It connects to the outside of the body for constant drainage. This can be done short-term in the hospital or more permanently for patients to drain fluid at home. An indwelling catheter always comes with a risk of infection.

Pleurodesis

Pleurodesis is a form of therapeutic surgery reserved for those with lung cancer and other similar conditions, including mesothelioma.

Although it doesn’t cure pleural effusions, it helps ease symptoms and reduce pain.

A pleurodesis procedure involves draining the excess fluid buildup from the pleura areas. The fluid should be emptied as much as possible for the best results.

Then, a surgeon or doctor administers either a chemical or mechanical pleurodesis:

• Mechanical pleurodesis is the most invasive of the two, which involves fusing the linings of both lungs together to prevent additional buildup.
• Chemical pleurodesis is much more common and less invasive. It involves inserting talc chalk into the chest via a tube and a small incision.

Once the talc is in the patient’s chest, they lie down for several hours, allowing the chalk to be distributed evenly. The talc is removed after its distribution, allowing the affected pleural areas to seal up.

Pleurectomy

A pleurectomy is surgery to remove some or all of the pleural tissue. Many patients with mesothelioma undergo this procedure as treatment for the cancer, but it can also resolve pleural effusion. It is an invasive procedure with many potential complications.

Pleural Effusion Prognosis

Pleural effusion is almost always the result of another, usually more severe, underlying condition, such as mesothelioma.

Although mesothelioma is treatable, there is currently no cure, and if it has progressed to the point of pleural effusion, the disease is usually in an advanced stage.

Consequently, the prognosis is typically poor. The treatments for pleural effusion are palliative rather than curative, meaning the main goal is to help reduce inflammation and pain and help the patient live more comfortably.

According to John E. Heffner, MD, FCCP, the average survival rate for patients with malignant pleural effusions involved in research on the disease was around four months. In a study of over 417 patients, only 13% survived a year after treatment.

Studies on minimal pleural effusion (less than 10 mm of fluid buildup) are ongoing. The Journal of Clinical Oncology suggests it is an early phase of the inevitable malignant pleural effusion.

Talk to your doctor as soon as possible if you have symptoms of pleural effusion, especially if you had contact with asbestos in the past. You may also want to contact an asbestos law firm to discuss your legal rights.

Legal Help with Pleural Effusion

If you’ve been injured by mesothelioma, asbestos-related lung cancer, or asbestosis, keep in mind that there is a good chance that you’ll qualify for considerable compensation. Don’t forget to fill out our form to get our free Financial Compensation Packet, filled with information on the experienced asbestos and mesothelioma attorneys in your area. If you have questions or need additional assistance, contact us at 800-793-4540.