Pleural Effusions and Ascites in Cancer Patients

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Pleural Effusions

A common complication in certain types of cancers is pleural effusion. Pleural effusion is an accumulation of fluid in the space between the two linings of the lungs. This space is covered with the pleura, a slick lining that provides a smooth interaction between the lungs, ribs and chest wall. When the space is filled with fluid, the contracting and relaxing of the lungs becomes more difficult.

There are two types of pleural effusions. Transudate pleural effusions are composed of fluids that enter the space through the blood vessel walls. This type of fluid accumulation is associated with congestive heart failure, liver failure or kidney failure.

The second type of pleural effusion is exudate pleural effusions. This is characterized by the inflammation of the pleura caused by diseases of the lungs. Several cancers produce exudate pleural effusions including breast cancer, lung cancer and lymphoma.

Symptoms and Treatment for Pleural Effusions

The most common symptom associated with pleural effusions is shortness of breath. Since the space between the linings of the lungs is filled with fluid, the diaphragm works harder to bring air into the lungs and expel air out of the lungs. The result is that the body isn’t receiving an adequate amount of oxygen.

Chest pain is another symptom of pleural effusions. It is related to the pleural lining, which is under more stress when the lungs inhale and exhale. The pain is particularly sharp when taking deep breaths. There may be pain in the shoulder or upper abdomen if the diaphragm becomes inflamed.

Pleural effusions and ascites in cancer patients can be addressed. Since pleural effusions are a complication of cancer, the cancer itself needs to be treated in order to reduce the pleural effusion. There are stop-gap measures to address the fluid accumulation, including the removal of the fluid through a thoracentesis. A tube thoracostomy can be performed as well to remove the fluid.


Another complication associated with several types of cancer is ascites. Ascites is the accumulation of fluid in the abdominal cavity. This is the region of the body below the diaphragm. The fluid is usually pale yellow and clear, originating from the serous gland.

Ascites which develop as a result of cancer is termed malignant ascites. The fluid appears during the advanced stages of cancers that affect the abdominal organs. This includes colon cancer, pancreatic cancer, stomach cancer and ovarian cancer.

Symptoms and Treatment for Ascites

Symptoms of ascites depends on the size of the fluid accumulation. Initially, there are no noticeable symptoms. As the fluid accumulates ( over 400 ml), the size of the abdominal area begins to visibly increase. Increased girth or a large belly are common. As the size increases, abdominal pain, discomfort and shortness of breath arises.

Pleural effusions and ascites in cancer patients are difficult to treat. Ascites is treated by treating the cancer. In some cases, surgical resection of the cancerous segments of the affected organ may reduce ascites. Chemotherapy is effective against cancer and may reduce the fluid accumulation in the abdominal cavity.


1. “Ascites.” MedicineNet.

2. “Pleural Effusion.” MedicineNet.