Anyone have malignant pleural effusion or ascites after surgery?

Posted by ur91 @ur91, Nov 14 11:12pm

Hi everyone,
I’m looking for input from anyone who has dealt with malignant pleural effusion or malignant ascites after esophageal cancer surgery.

My mom (57) was diagnosed earlier this year with GEJ esophageal adenocarcinoma, originally staged T3N0M0 on EUS and PET. She completed full neoadjuvant chemoradiation and had a near-complete response at the primary tumor. She then had an esophagectomy in September, with clear margins, but pathology showed 6 out of 22 positive lymph nodes, making it pT3N2. No distant disease was ever seen on scans.

A few weeks after surgery she developed severe nausea/vomiting and a lot of fluid in her chest and abdomen. Today we learned that the fluid they drained from her lung tested positive for cancer cells, and they strongly suspect the abdominal fluid will be positive too (results pending). The doctors said this means a diffuse metastatic recurrence (pleural + possible peritoneal) and that this is now considered Stage IV.

They told us they need to get her stabilized and able to tolerate J-tube feeding before starting any further chemo/immunotherapy.

I’m hoping to hear from anyone who has been through something similar:
- Did anyone else have malignant fluid but still respond to treatment?

Any research on it brings back the worst types of outcomes. We’re really looking for some hope during this. We thought the outlook was good given the initial staging and success on the surgery but this just turned everything around.

Any experiences, advice, or perspective would be really appreciated.

Thanks

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@ur91, that must've been hard news to hear that, after chemoradiation and surgery, cancer cells were found in the fluid around your mom's chest and abdomen. I'm tagging a few members like dorenemonchil @ollusam @davidwrenn @rybar8, who have talked about pleural effusion and/or ascites and esophageal cancer, although I'm not sure they were dealing with malignant pleural effusion and/or ascites.

Has your mom had success with the J-tube? What chemo/immunotherapy protocol is being recommended? And, how are YOU doing?

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Cancer sucks… this is the worst… my dad 2/24 dx Esophegeal Ca… chemo rad great response… surgery… clean started immunotherapy after… then 12/24 spots on liver tried to biopsy unsuccessful.. started chemo again 2/25.. did 5 rounds scans good …they wanted total of 12 rounds.. at tound 3 they added Vyloy…round 4/5 started with feet and ankle swelling.. albumin decreased , not taking in enough protein… stopped round 9 (6/17/25) the 8/16 fell and broke his hip… his docs wanted total do radiation… I did not feel comfortable… they continued and pushed only radiation.. I took him for a 2nd opinion they said NO RADIATION…. New scans show growths and new places… also ascites 4.5 liters drained… all tested positive for cancer.. spots in lungs .. docs still say start chemo again.. prayers up

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Profile picture for rybar8 @rybar8

Cancer sucks… this is the worst… my dad 2/24 dx Esophegeal Ca… chemo rad great response… surgery… clean started immunotherapy after… then 12/24 spots on liver tried to biopsy unsuccessful.. started chemo again 2/25.. did 5 rounds scans good …they wanted total of 12 rounds.. at tound 3 they added Vyloy…round 4/5 started with feet and ankle swelling.. albumin decreased , not taking in enough protein… stopped round 9 (6/17/25) the 8/16 fell and broke his hip… his docs wanted total do radiation… I did not feel comfortable… they continued and pushed only radiation.. I took him for a 2nd opinion they said NO RADIATION…. New scans show growths and new places… also ascites 4.5 liters drained… all tested positive for cancer.. spots in lungs .. docs still say start chemo again.. prayers up

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@rybar8, cancer definitely sucks. Sorry to hear about your dad's new lesions in new places, all positive for cancer. Has he started chemo again? How is he doing?

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