Management of malignant pleural effusions.

Malignant pleural effusions are a common complication of advanced cancer, particularly breast and lung cancers. Clinical algorithms for the diagnosis and management of malignant pleural effusions form a framework for the cost-effective provision of meaningful palliation. When the entire episode of care is considered, the optimal therapy for malignant pleural effusions appears to be tube thoracostomy followed by intrapleural bleomycin. Alternative strategies for the delivery of intrapleural therapy (eg, soft catheters) and new intrapleural agents currently are being compared with standard therapy.