Malignant Pleural Effusion (MPE)

Malignant Pleural Effusions (MPE) are a complication of advanced cancer that can contribute to poor quality of life and significant morbidity. Identification and effective management of malignant pleural effusions are key in maintaining quality of life for people with cancer.

It is important that all health professionals are able to:

• recognise the signs and symptoms of malignant pleural effusions
• assess the severity
• initiate the right interventions and escalate care appropriately.

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Module

Case study podcasts

This Rapid Learning edition we hear from Renata Jolly, clinical nurse consultant, and senior nurse Jaypee Valenzuela who each share a unique clinical case study of caring for a patient with malignant pleural effusion. 

Mini quiz 

Download the eviQ Education app to access exclusive content, including the MPE mini quiz and seven other oncological emergency interactive lessons. Use the QR code to access to MPE mini quiz, or visit our mini quizzes homepage for more information.

Continue your learning

• MPE summary sheet
• ESMO Handbook of Oncological Emergencies
• Malignant pleural effusion: from bench to bedside
• The oncology nurse: Malignant pleural effusions

Patient information

• Macmillan UK: Pleural effusion - patient information

Evidence based summaries, guidelines and recommendations

• A summary of the optimal management of malignant pleural effusions has been developed in the Clinical practice guidelines for the treatment of lung cancer.¹
• Management of Malignant Pleural Effusions. An Official ATS/STS/STR Clinical Practice Guideline
• ERS/EACTS statement on the management of malignant pleural effusions

Reference list

1. Clive, A.O., Jones, H.E., Bhatnagar, R., Preston, N.J. and Maskell, N., 2016. Interventions for the management of malignant pleural effusions: a network meta‐analysis. Cochrane Database of Systematic Reviews, (5).
2. Mongardon, N., Pinton-Gonnet, C., Szekely, B., Michel-Cherqui, M., Dreyfus, J.F. and Fischler, M., 2011. Assessment of chronic pain after thoracotomy: a 1-year prevalence study. The Clinical journal of pain, 27(8), pp.677-681.
3. Roberts, M.E., Neville, E., Berrisford, R.G., Antunes, G. and Ali, N.J., 2010. Management of a malignant pleural effusion: British Thoracic Society pleural disease guideline 2010. Thorax, 65(Suppl 2), pp.ii32-ii40.
4. Karkhanis, V.S. and Joshi, J.M., 2012. Pleural effusion: diagnosis, treatment, and management. Open access emergency medicine: OAEM, 4, p.31. 
5. Emergency Care Institute NSW. Pleural effusion. 2020. Agency for Clinical Innovation, NSW Health. Available from: https://aci.health.nsw.gov.au/networks/eci/clinical/clinical-resources/clinical-tools/respiratory/pleural-effusion
6. Hooper, C., Lee, Y.G. and Maskell, N., 2010. Investigation of a unilateral pleural effusion in adults: British Thoracic Society Pleural Disease Guideline 2010. Thorax, 65(Suppl 2), pp.ii4-ii17.
7. Kosmidis, P.A., Schrijvers, D., Andre, F. and Rottey, S. eds., 2005. ESMO Handbook of oncological emergencies. CRC Press.
8. Bibby, A.C., Dorn, P., Psallidas, I., Porcel, J.M., Janssen, J., Froudarakis, M., Subotic, D., Astoul, P., Licht, P., Schmid, R. and Scherpereel, A., 2019. ERS/EACTS statement on the management of malignant pleural effusions. European journal of cardio-thoracic surgery, 55(1), pp.116-132.
9. Cancer Council Australia Lung Cancer Guidelines Working Party. Clinical practice guidelines for the treatment of lung cancer. 2017. Sydney: Cancer Council Australia. Available from: https://wiki.cancer.org.au/australia/Guidelines:Lung_cancer.