Fluid in the Lungs/Chest Cavity

[Iratama]

My 74 year old mother has Secondary Bone/Brain Cancer (as explained by my father) was diagnosed at Stage 4 terminal about a year and a half ago.  Last Thursday after complaints of not being able to breathe comfortably, the local hospital removed close to 2 litres of fluid from her chest through the back.  When I asked if it was from the lungs or the cavity - all she could tell me was that she thought it was between the lungs and a lining of some sort.  I am simply looking for some understanding of what's happening as my parents are keeping things quite secretive.  Is this a sign that the cancer may have moved into the lungs?

[Kamal S Saini, MD, MRCP (UK), DM]

Hi Robin,
I am afraid that with no medical support, her extensive disease can result in a number of complications, and the outcome may be unpredictable.
You should urge her to accept at least basic palliation, especially for pain and breathlessness. This will make her last days much more comfortable.
Be strong. God Bless.

[Iratama]

Thank you for your response.  I just thought I'd share that my mother refused Pallative Treatment, the hospital offered aggressive chemo (to shrink the tumor) - she also refused and she had them remove the intercostal tube so that she could go home.  This has greatly shortened her time ~ hasn't it?.

Thank you for everything.

Robin

[Kamal S Saini, MD, MRCP (UK), DM]

Hi Robin,
I can imagine that this is a very difficult time for you and the rest of the family.
Advanced lung cancer with malignant pleural effusion has a generally poor outlook (I never like to mention specific timelines as these can vary widely from patient to patient). The life expectancy may be somewhat improved with palliative treatment - either chemotherapy or radiotherapy (although at the cost of side effects), along with supportive care like having a "intercostal tube" placed between her ribs, to drain the fluid into a bag. Pain relief, antibiotics, cough suppression, etc would help relieve her symptoms and improve her quality of life.
All the best, and be strong!

[Kamal S Saini, MD, MRCP (UK), DM]

Hi,
From your description, I think that "pleural tapping" was done, where fluid was removed from the pleural cavity that lines the lung. This may signify advanced cancer, especially given your mothers clinical history.
Please discuss with your father about how she is doing, what the doctors have told them etc. This is a very difficult time for your father and the rest of the family, and you should have good, open communication and offer all the support that you can.
All the best, and God Bless!

[Reasa]

My mother in law is in a similar situation. Except she has the drainage tube to drain the fluid. One hospital which I will not name wanted us to release her into hospice but she said she didn't want it. Me and my husband brought her with us to a hospital that specialized in cancer. That hospital didn't put her in hospice. Oh and may I also add my mother in law also is taking the chemo therapy. She was taking morphine and now oxictin and oxycodone does that means the cancer is getting worse. And what are some signs of this type of cancer getting worst?

[Iratama]

Thank you so much for your response.  I have confirmation of your comment.  This is advanced Lung Cancer.  We had mom in the hospital since friday and she forced the doctors to release her yesterday , I know that this is becaus all 7 of her children are here, together for the 1st time in 15 years and she did not want to spend the time in the hospital.  We got confirmation of a "massive" tumor that is not allowing the lung to re-inflate and as they drain the fluid it does return, approx. 1/2 to 2/3 of a litre per 12 hour day.  In the ex-rays (of which I only caught a passing glance) this tumor looks to be the size of almost half of her entire chest cavity and when the doctors gave us a visual, it looked like he was imagining holding a football! My mom has refused any treatment as she does not want the remaining days of her life spent in a hospital bed too sick to enjoy her family.  I guess my question is ... does her reference to the word "days" sound accurate?  I hve a strong feeling that mom could be gone within the week and I'm having sooo many conflicting emotions and thoughts that I can't seem to even make sense of any of this!  Do you have any ideas of a time line for me?  Anything at all?

Thank you in advance for "Anything" you can tell me.

Robin