Pleural Effusion in Breast Cancer: Symptoms and Treatment Options

Q: Pleural Effusion in Breast Cancer: Symptoms and Treatment Options

1. <br>Is this considered lung cancer? A： This is breast cancer with lung metastasis. <br> <br>2. <br>Additionally, recently it has become more severe; after taking the medication (XELODA) prescribed by the doctor, I experience intermittent sharp pain and numbness on the left sid

About breast cancer causing pleural effusion?

I would like to ask: Seven years ago, a relative was diagnosed with a tumor in the chest, which was surgically removed and followed by chemotherapy.
Recently, they suddenly started experiencing shortness of breath while walking and persistent coughing at night, and it has been confirmed that cancer cells have spread, leading to pleural effusion.
Does this count as lung cancer? Additionally, more recently, after taking the medication prescribed by the doctor (XELODA), they have been experiencing intermittent sharp pain and numbness on the left side of the abdomen.
Is this a reasonable side effect? Since my relative could not tolerate it, they stopped taking the medication.
Recently, they have also developed a hoarse throat, and I am unsure if this is due to cancer cells invading the recurrent laryngeal nerve, causing vocal cord closure issues.
The pleural effusion has persisted for about three to four months, and they have been receiving drainage treatment.
The hoarseness has lasted for three weeks.
Are these symptoms serious? My relative does not want to undergo chemotherapy or surgery anymore.
If they only continue with medication and drainage, is recovery possible? Furthermore, the attending physician mentioned that cancer recurrence seven years later is not considered too severe; is this perspective correct? Lastly, are there any dietary considerations or foods that could help improve their condition? I sincerely request your clarification, thank you.

Yang Mie Mie, 20~29 year old female. Ask Date: 2013/06/15

Dr. Chen Sirong reply Oncology

1.
Is this considered lung cancer? A: This is breast cancer with lung metastasis.

2.
Additionally, recently it has become more severe; after taking the medication (XELODA) prescribed by the doctor, I experience intermittent sharp pain and numbness on the left side of my abdomen.
Is this situation reasonable? A: Xeloda can cause hand-foot syndrome (tingling, numbness, pain, swelling, or redness in the palms or soles), rashes, dryness, or itching of the skin.
To alleviate hand-foot syndrome, you can apply a cold cream rich in lanolin to the affected area and take oral Vitamin B6 (Pyridoxine) for treatment.
If symptoms are severe, the dosage should be reduced or treatment should be paused.
Your relative's symptoms should be as described, just occurring in the abdomen.

3.
Recently, I have started to experience a hoarse throat; could this be due to cancer cells invading the recurrent laryngeal nerve, causing vocal cord closure issues? A: This is a plausible hypothesis, but to confirm it, a CT scan may be necessary.
However, whether or not to perform a scan does not affect treatment, so it may not be necessary to do a scan just for confirmation.

4.
If I only follow the medication regimen and have drainage, will I recover? A: If the disease has spread, it cannot be cured, only temporarily controlled.
The average survival time for breast cancer patients after distant metastasis is about two to two and a half years, but there are still a small number of patients who may have a longer survival opportunity.
There have been cases of survival for five years, but this is rare and does not mean a cure; it is merely controlled, or it may involve switching from first-line to second-line treatment until no effective medication is available or the body can no longer tolerate it.

5.
The attending physician mentioned that cancer infections occurring seven years later are not considered too severe; is this perspective correct? A: Your wording does not align with medical terminology.
Cancer only metastasizes and does not cause infections.
The idea that metastasis occurring seven years later equates to living seven more years is not considered too severe (not too bad), but once the disease has metastasized, it cannot be cured and is indeed serious.

6.
Lastly, are there any dietary considerations or foods that may help improve the condition? A: Maintaining weight and physical strength is crucial for longevity; as for what to eat, anything is fine.
Thank you for your inquiry.
Chen Si-Rong.

Reply Date: 2013/06/15

More Info

Pleural effusion, which is the accumulation of fluid in the pleural space surrounding the lungs, can be a significant complication in patients with breast cancer, especially when the cancer has metastasized. In your relative's case, the history of breast cancer followed by the recent diagnosis of pleural effusion suggests that the cancer may have spread to the lungs, which is a common site for metastasis in breast cancer patients. While pleural effusion itself does not equate to lung cancer, it can indicate that the breast cancer has progressed and is affecting lung function.

The symptoms your relative is experiencing, such as shortness of breath and persistent cough, are typical of pleural effusion. The fluid accumulation can compress the lung, leading to difficulty breathing and discomfort. The fact that these symptoms have persisted for several months indicates that the effusion may be significant and warrants ongoing management.

Regarding the use of Xeloda (capecitabine), it is known to cause side effects such as gastrointestinal discomfort, including abdominal pain and neuropathy, which can manifest as tingling or numbness. If your relative is experiencing these symptoms, it is reasonable for them to discuss these side effects with their healthcare provider. In some cases, dosage adjustments or alternative treatments may be necessary to manage side effects effectively.

The hoarseness your relative is experiencing could indeed be related to the cancer's impact on surrounding structures, including the recurrent laryngeal nerve, which can be affected by metastatic disease. This symptom should be evaluated by a healthcare professional, as it may require imaging studies to assess the extent of any potential nerve involvement.

As for the treatment options, if the cancer has metastasized, the goal of treatment typically shifts from curative to palliative, focusing on symptom management and quality of life. While chemotherapy may not be the preferred option for your relative due to their age and the potential for severe side effects, other treatments, including targeted therapies or supportive care measures, may be appropriate. The decision to forego chemotherapy in favor of medication and fluid management should be made in consultation with the oncologist, who can provide guidance based on the specific circumstances and overall health of your relative.

Regarding the oncologist's comment about the cancer spreading seven years after the initial diagnosis not being "too serious," this perspective can be misleading. While it is true that some patients may live for several years without recurrence, the emergence of metastatic disease generally indicates a more advanced stage of cancer, which can complicate treatment and prognosis. Each case is unique, and the overall health, age, and preferences of the patient play a crucial role in determining the best course of action.

In terms of dietary considerations, maintaining a balanced diet is essential for overall health, especially in cancer patients. While there is no specific diet that can cure cancer, a nutritious diet can help support the immune system and improve quality of life. Encouraging your relative to eat a variety of fruits, vegetables, whole grains, and lean proteins can be beneficial. Additionally, staying hydrated is crucial, especially if they are undergoing treatments that may lead to dehydration.

In summary, your relative's situation is complex, and it is vital to have open discussions with their healthcare team about symptoms, treatment options, and overall goals of care. Supportive care measures, including managing pleural effusion and addressing side effects from medications, are essential components of their treatment plan.

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