Patient case (clinical description): A 61-year-old man comes to the clinic due to nonproductive cough and progressive dyspnea.  The patient's medical conditions include hypertension, hypercholesteremia and peptic ulcer disease.  He smokes 2 packs of cigarettes daily for the past 30 years.  On examination, there are decreased breath sounds and percussive dullness at the base of the left lung.  Other vital signs are normal. Abdomen is soft without tenderness. CT scan shows a left-sided pleural effusion and nodular thickening of the pleura. The plural fluid was bloody on thoracentesis. Biopsy shows proliferation of epithelioid-type cells with very long microvilli.

Patient's own account: I am 61 and I had to go to the clinic because I couldn't stop coughing and I experienced some breath shortness. I suffer from hypertension and cholesterol and I also have a stomach ulcer. I should admit that I've been smoking 2 packs of cigarettes every day for the past 30 years. My doctor told me that my breath in my left lung sounds bad. But he told me that my blood pressure, heart rate, breathing rate and temperature are normal. My belly is also normal. However my X-Rays show some liquid on the left side and a mass where the liquid got hard. The scary thing is that the liquid was bloody when they got it out. They did a biopsy and it showed that I have an increase of epithelioid-type cells with very long microvilli.

Clinical trial: Ibuprofen or Morphine in Treating Pain in Patients Undergoing Pleurodesis for Malignant Pleural Effusion

Eligibility criteria:
DISEASE CHARACTERISTICS:

          -  Diagnosis of malignant pleural effusion requiring pleurodesis confirmed by 1 of the
             following:

               -  Histologically proven pleural malignancy

               -  Typical features of pleural malignancy seen on direct vision during thoracoscopy

               -  Pleural effusion in the context of histologically proven cancer elsewhere

          -  No primary lymphoma or small cell lung carcinoma

          -  All patients undergoing thoracoscopy for suspected malignant pleural effusion are
             eligible

        PATIENT CHARACTERISTICS:

          -  Life expectancy > 1 month

          -  Not pregnant or nursing

          -  No history of GI bleeding or untreated peptic ulceration

          -  No known sensitivity to non-steroidal anti-inflammatory drugs (NSAIDs), opiates, or
             paracetamol

          -  No hypercapnic respiratory failure

          -  No known intravenous drug abuse

          -  No severe renal or liver disease

          -  No known bleeding diathesis

          -  Able to give informed consent

        PRIOR CONCURRENT THERAPY:

          -  More than 2 weeks since prior and no concurrent corticosteroid therapy

          -  No concurrent warfarin therapy

          -  No other concurrent analgesics

               -  Analgesics used as a breakthrough regimen are allowed from trial entry to tube
                  withdrawal at day 3 post-pleurodesis (i.e., regular paracetamol, assigned study
                  analgesia, and breakthrough medication only, including opiate slow release
                  patches)

          -  No concurrent enrollment on another clinical study

               -  Patients may participate in other trials immediately after completion of current
                  trial, excluding those involving further pleural procedures or analgesia trials
                  in which patients must wait at least 3 months after completion of current trial
No condition on gender to be admitted to the trial.
No healthy subjects accepted to join the trial.
Subject must be at least 18 Years old.


Eligibility (NLI label): Entailment