Diuretic Therapy for Malignant Effusion

John B. Weeth, M.D.; Albert Segaloff, M.D.
JAMA. 1962;181(3):258-260. doi:10.1001/jama.1962.03050290080017a.
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RETENTION of fluid is often a most troublesome symptom of patients with cancer. Relieving the patient of abnormal collections of fluid makes him more comfortable and frequently enables him to resume his normal daily routine. We should like to review briefly the available therapy of this problem, emphasizing the beneficial results of oral administration of diuretic agents, particularly the thiazide diuretics and an aldosterone antagonist (spironolactone).

Successful antineoplastic chemotherapy is an effective answer to malignant effusion. If the malignant process cannot be controlled, local antineoplastic therapy may still be of benefit. Injection of oncolytic chemotherapeutic agents into the pleural or peritoneal space, after withdrawal of as much of the fluid as possible, can be an efficient longterm method of controlling effusion due to malignant tumors. Nitrogen mustard, 0.2 to 0.6 mg. per kilogram of body weight, is widely used for this purpose. Radioactive isotopes have also successfully controlled certain types

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