Non-small cell lung cancer (NSCLC) is the most common type of lung cancer in the United States. About 84% of all lung cancer cases are NSCLC. It’s also usually less aggressive than small-cell lung cancer (SCLC).

A effusion is fluid around the lungs. Injuries to your chest can cause a condition called pleural effusion. Lung cancer is associated with increased survival odds and the development of pleural effusion.

New research shows that people with lung diseases might have a better outlook if they are treated aggressively.

Pleural effusion is the buildup of fluid between the layers of membranes that line your lungs and the inside of your chest cavity. These membranes are called pleura. There’s always a small amount of fluid in the pleura that acts as a lubricant to help you take in and expel air.

Too much fluid builds up in the pleura is called pliural effusion. It is also called water on the lungs.

Symptoms of effusion include:

Doctors often check for pleural effusion during NSCLC diagnosis. Doctors can do a few different tests to check for pleural effusion. These tests include:

  • Chest X-ray: A chest X-ray can take images of the lungs to look for fluid buildup.
  • Chest CT scan or ultrasound: An imaging test such as a chest CT scan or ultrasound can create detailed images of the lungs.
  • Thoracentesis: Thoracentesis uses a needle between the ribs to remove a sample of fluid for examination in a lab.
  • Thoracoscopy: A thoracoscopy uses tiny cameras to allow doctors to see and treat the effusion at the same time. You’ll be under general anesthesia during the procedure.

Pleural effusion can be a sign that NSCLC has spread beyond the original tumor location. People whose NSCLC is at a higher stage are more likely to experience pleural effusion. In many cases, the presence of pleural effusion at diagnosis means the NSCLC has already advanced to stage 4.

But this isn’t always true. Pleural effusion can sometimes be the first symptom of lung cancer. It can also be due to complications of lung cancer.

The underlying cause of the pleural effusion will be the reason why your doctor will need to determine the exact stage of your cancer.

The cancer is stage 4 if the underlying cause is the lung cancer. If the underlying cause is something other than NSCLC, your stage will depend on factors such as tumor size and whether it has spread to your sputum or surrounding tissues.

Doctors typically consider pleural effusion to be a sign of a poor outlook for people with NSCLC. But recent studies (1, 2) suggest that more aggressive treatment of NSCLC with pleural effusion can help improve the survival odds of people with otherwise minimal disease (when cancer hasn’t spread beyond the chest).

Other factors and when pleural effusion develops will affect your treatments. Options can include:

  • Thoracentesis: Doctors use this procedure both to diagnose and treat pleural effusion.
  • Tube thoracostomy: In a thoracostomy, doctors insert a tube into your chest for a day or more to drain fluid.
  • Catheter: Doctors can place a catheter into your chest to drain fluid. They may use this option when fluid drainage needs to be ongoing.
  • Shunt: A shunt is a surgically inserted tube doctors use to move fluid from one area of your body to another.
  • Chemotherapy: In some cases, treating NSCLC with chemotherapy is also the best treatment for pleural effusion.

Until recently, doctors didn’t consider people with NSCLC and pleural effusion as candidates for tumor removal surgeries.

But research has found that surgery can benefit some people with NSCLC and pleural effusion after receiving standard care. A 2019 study found that surgery improved the survival rate for people with minimal disease, meaning cancer that hasn’t spread beyond their chest.

Initial results are promising, but more research is needed.

Doctors typically consider pleural effusion a sign of advanced NSCLC, and the outlook can be challenging. Once NSCLC is in later stages, the 5-year survival rate is 8%.

The survival rates are based on the data from a long time ago. The data was collected between 2011 and 2017: The current number is likely to rise with the advancement of treatment.

If you have pleural effusion and NSCLC, your doctor might talk with you about palliative care. Palliative care can help you manage your NSCLC.

“Hospice and Palliative care are not the same, and it doesn’t mean your doctor expects you to die quickly. You can receive extra medical, social, and mental health support while you manage your cancer.”

If you have questions about the disease, you can read the answers to them.

How common is pleural effusion in NSCLC?

About 8% to 15% of people with NSCLC have pleural effusion at the time of NSCLC diagnosis. About 40% to 50% of people with NSCLC will develop pleural effusion.

What increases my risk for pleural effusion?

The biggest risk factors for pleural effusion are also the biggest risk factors for NSCLC itself. These include smoking, exposure to secondhand smoke, and environmental factors. Other risk factors include contact with asbestos.

Is pleural effusion more common with some types of lung cancer?

Pleural effusion is more common in people with adenocarcinoma than in other types of NSCLC.

There is a build up of fluid in the chest wall. It can be seen that cancer has spread and is progressing to a late stage when pleural effusion occurs.

“Doctors don’t recommend surgery for people with non-stagnant lung cancer because of a poor outlook.”

“New research suggests that more aggressive treatment may be possible if cancer hasn’t spread beyond your chest. There is more research needed to determine if surgery can be an option for people with lung diseases.”

Talk to your doctor about the options that are right for you.