Information
A malignant pleural effusion is a build up of fluid containing cancer cells between the membranes that line the lungs. This condition is a sign that the cancer has spread, or metastasized, to other areas of the body. Common cancers that cause malignant effusions include lymphoma and cancers of the breast, lung, and ovary. A malignant pleural effusion is treatable. But it can be a serious and potentially life-threatening condition.
Most common symptoms are shortness of breath, dry cough, pain, feeling of chest heaviness or tightness, inability to lie flat.
All invasive pleural interventions should be performed under the auspices of appropriately trained clinicians in the respiratory department.
M.A, K.E & J.W. 12-2-26
Who to refer:
All patients with a cancer diagnosis with symptoms suggestive of a malignant pleural effusion should be discussed with pleural service.
Who not to refer:
If in doubt please do not hesitate to call Edinburgh Cancer Centre Acute Oncology team on 07798774842 or 0131 537 1000. You may be advised to refer via medical team.
How to refer:
The contact email for the pleural service (non-urgent referrals) is: loth.pleuralservicewgh@nhs.scot. Alternatively, if more urgent advice, is needed contact the respiratory team on call via NHS Lothian Switch (0131 537 1000).
All patients on or within six weeks of treatment should be encouraged to monitor symptoms and call The Cancer Treatment Helpline (CTH; 08009177711) with any treatment-related concerns. Please note, the CTH is a call operator service provided by NHS 24, who then refer on to an acute care specialist. They cannot give specialist advice.
If the patient has been assessed by a healthcare practitioner in Primary Care, and Oncology advice/input is felt to be required, the Primary Care clinician should call the Acute Oncology team at the Edinburgh Cancer Centre (based in the WGH) and discuss directly. The Acute Oncology team can be contacted during working hours (Mon-Fri 9-5) on 07798774842; If out of hours, please discuss with the Oncology Registrar On-Call via NHS Lothian Switchboard (0131 537 1000).
If the primary care clinician requires any further guidance on the suitability of referral to Acute Oncology, they can consult Pg 10 of the The UKONS Oncology/Haematology 24 Hour Triage Toolkit.
Note if a patient has presented to primary care for assessment, the patient should NOT be advised to call the CTH themselves to pass on this information or seek further advice.
Link to Acute Oncology Initial Management Guidelines:
UKONS | Acute Oncology Initial Management Guidelines (sundownsolutions.co.uk)












