| Abstract: | Pleural and peritoneal effusion secondary to primary malignancy is a significant problem in the management of the cancer patient. Respiratory embarrassment and discomfort associated with the formation and collection of fluid in the chest and abdomen are among the most distressing symptoms encountered as a result of malignant disease. The guidelines for treatment should be based on respiratory symptoms, and with the understanding that the procedure is palliative. Both surgical and medical forms of treatment have been used. These include thoracostomy-tube drainage alone or with the instillation of antimicrobial agents. Pleurectomy is effective but should be reserved for situations in which conservative approaches have failed. Antitumor agents, such as nitrogen mustard, are effective but toxic. The mode of action of antineoplastic agents is related to their ability to cause pleural sclerosis and obliterate the pleural space. Systemic chemotherapy and external beam radiation are rarely effective. The intracavitary application of radioactive colloids has been used since 1945. Colloidal radioactive gold Au 198 has been replaced by the pure beta emitter, colloidal chromic phosphate P 32. Instillation of a colloidal suspension of radioactive phosphorus represents a significant and effective palliative therapeutic modality for malignant effusion. |
