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Fatigue and malignant pleural effusions
  1. Avinash Aujayeb1 and
  2. Donna Wakefield2
  1. 1 Respiratory Department, Northumbria Healthcare NHS Foundation Trust, North Shields, UK
  2. 2 Palliative Care Department, North Tees and Hartlepool NHS Foundation Trust, Stockton-Upon-Tees, UK
  1. Correspondence to Dr Avinash Aujayeb, Northumbria Healthcare NHS Foundation Trust, North Shields NE23 6NZ, UK; avinash.aujayeb{at}

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Dear Editors

We completely agree with Twose et al 1 that until now the primary focus in both clinical practice and trials has been on interventions in malignant pleural effusions (MPEs), tailored to mitigating breathlessness and preventing admissions, with little consideration of other factors potentially of greater priority to the patient. We were encouraged to see that constitutional symptoms such as fatigue and anorexia were investigated, but disappointed that the effects of aspiration were not sustained at 7 days. Our interest lies in fatigue in MPEs. Cancer-related fatigue is well described and is a subjective symptom experienced by patients at all stages of disease and can occur during treatment, in advanced disease and in disease-free survivors.2 Approximately 40% …

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  • Twitter @avinashaujayeb, @DonnaWakefield_

  • Contributors Both authors wrote the manuscript together.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.