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Asbestos and Pleural Effusion

Pleural effusion is not an asbestos disease, but a condition that is often caused by many of the diseases that result from exposure to asbestos, including asbestos-related lung cancer, asbestosis, and mesothelioma. The condition, which is a build-up of fluid in the pleural cavity in response to inflammation and disease, can happen just once or can become a chronically-recurring problem that causes severe discomfort and can eventually lead to additional scarring and damage to the lungs. Though pleural effusions are not in and of themselves fatal, the thickening they can cause the pleura to undergo and the pain and pressure that they create can significantly contribute to the patient’s misery and distress.

Symptoms of Pleural Effusion

Every patient who experiences pleural effusion is unique: some may suffer from the condition only occasionally and with one or two symptoms, while in others it may become a chronic occurrence that is characterized by multiple symptoms and complications. The symptoms that are most typical of pleural effusion include:

  • Dry hacking cough
  • Significant pain in the chest, and particularly when inhaling or trying to take a deep breath
  • Overall feeling of discomfort
  • Frequent hiccups
  • Shallow, short breaths
  • Unable to breathe easily while reclining or laying down (orthopnea)

Diagnosing pleural effusions requires a number of tests and a thorough examination by a physician, and the condition often requires treatment. If you have been diagnosed with an asbestos-related disease and are experiencing any of these symptoms, you should seek medical treatment immediately, as the condition is likely to worsen.

Causes of Pleural Effusion

As is true with other parts of the body, one of the ways that the pleural cavity responds to inflammation and disease is by generating a fluid. When the body senses the pressure, pain, or inflammation caused by asbestos-related lung cancer, asbestosis, mesothelioma and other asbestos-related diseases, it creates either a watery fluid build-up called transudative effusions or a protein-filled fluid called exudative effusions. Both can cause severe discomfort.  

Asbestos-related diseases are not the only reason that the lungs form pleural effusions. They sometimes occur as a reaction to medication or radiation therapy, or may also be a result of pulmonary diseases, cirrhosis, heart failure, a reaction to open-heart surgery or stomach surgery, kidney diseases, or pneumonia. Some autoimmune diseases can cause pleural effusions, and so can chest trauma following automobile accidents or sports injuries.

Diagnosing Pleural Effusion

There are a number of diagnostic tools available to physicians who suspect that a patient is suffering from pleural effusions. The doctor will first conduct a thorough physical examination, looking for typical symptoms of pleural effusion including a weakened voice, an inability to take a deep breath and abnormal chest sounds. Though most rely upon the use of X-rays which allow a clear view of the pleura and any buildup of fluid within, they may also order a chest ultrasound or a CT scan for an even clearer assessment of how much fluid is present. In some cases, a patient may experience symptoms despite the fact that the fluid is not abundant. If the physician suspects that the patient has pleural effusion they are able to conduct a thoracoscopy. This procedure involves making a small incision in the chest and inserting a thin tube that allows a direct view of the entire chest region, including the pleura and lungs. Where fluid is present, a small sample is removed through the thoracoscope so that it can be analyzed in the laboratory for the presence of infection or malignant cells.

Treatment for Pleural Effusion

As a result of the many varying reasons why pleural effusions may occur, there are also a number of different treatments that are used. For patients who experience effusion as a result of heart failure the most appropriate response is a combination of medications. In the most acute cases the patients may be treated with protocols typically used in cancer patients, including chemotherapy and radiation therapy. Patients who have pleural effusions as a result of an illness impacting the respiratory system, such as pneumonia, frequently have the fluid drained via thoracentesis.  For those whose condition does not respond adequately to thoracentesis, there are also drugs that can be administered to minimize the scarring that often occurs with the effusions. This protocol is commonly used on mesothelioma patients, though in some cases surgery may be required if the condition becomes chronic.

Pleurodesis

The surgery that is used to treat pleural effusions is known as pleurodesis. It is usually reserved for extreme cases such as patients who are suffering from mesothelioma or some other form of lung cancer. The procedure involves first removing as much fluid as possible from the patient’s chest, then either inserting talc chalk or surgically fusing the lung lining together. The first of these two options is known as chemical pleurodesis, while the latter is mechanical pleurodesis, which is a more invasive process.

Prognosis for Patients with Pleural Effusion

Pleural effusion is generally a symptom of another condition. This means that in some cases it may be nothing but a complication that will eventually diminish and disappear once the originating symptom has been treated, but in other cases it may be an indication that the originating symptom has worsened and is at an end stage. This is the case with mesothelioma. When a mesothelioma patient is diagnosed with chronic pleural effusion, it is generally a sign that the condition is significantly advanced, and the patient generally has less than four months to live.  At this point the goal of treatment is often to preserve the patient’s quality of life and make them as comfortable as possible.