A patient-centred approach to malignant pleural effusion

Malignant pleural effusion (MPE) occurs in up to 20% of malignancies, most commonly from a breast or pulmonary primary. It confers a poor prognosis, with a median survival of less than a year, and the mainstay in treatment has previously been achieving pleurodesis.

This review provides an overview of the most up to date literature for the treatment of MPE using a PubMed search, with a focus on patient-centred care.

There is increased focus on outpatient management and control of symptoms for patients with MPE, allowing more in-depth conversations to be had over what individual patient goals are. The development of new approaches such as indwelling pleural catheters (IPC) and local anaesthetic thoracoscopy (LAT) also increase the options available. When manging the complexities of MPE, such as non-expansile lung and septated effusions, various approaches can be taken to treat them including fibrinolytics and IPC.

The treatment of MPE has changed in the last 15 years to focus on outpatient management and symptom control. Careful discussions must be undertaken on a patient-by-patient basis.