The current approach in managing effusions in the Cancer Research Institute Clinical Unit is as follows. Initial attempts are made to control the process with systemic chemotherapy, using diuretics as indicated. If the patient requires frequent taps, or is symptomatic from his effusions, an alkylating agent is instilled locally. Nitrogen mustard is generally used intrapleuraliy and Thio-TEPA intraabdominally because of ease of use, inexpensiveness, availability, and relative freedom from side effects, as well as their high degree of effectiveness. If two or three instillations fail to control the effusion, the patient is then referred either to the radioisotope or surgery service depending on the case.