Hi, mlk. . .
It is important that you do not restart on Sprycel until the PE is completely resolved. Only an x-ray read by a radiologist will be able to tell you that.
Whether or not to drain the fluid depends on how much fluid there is. An ultrasound will show that. On my first PE they drained just under 2 liters of fluid. That was bad. The second one was about 1 liter. I'm not sure where the cutoff is on draining vs. letting it resolve on its own. I have heard of people who didn't have them drained taking water pills to help with the process.
I would encourage you to talk to your oncologist about reducing dosage. . .PE is a significant side effect. It's not a huge deal to drain the fluid, except that every time you do it, you run the slight risk of introducing an infection in your chest cavity, which can be serious. That said. . . the doc that drained mine (Dr. Schott. . .isn't that a great name for a guy with a needle??!) said that there are people with certain conditions who have PEs drained regularly. . . it's a safe procedure to do repeatedly.
A few years ago, my oncologist was pretty adamant about staying with the standard dose of Sprycel, but as new research and protocols are coming out, he has been willing to try lowered dose (I'm currently on 50 mg). I'm slowly working my way back down to PCRu (last week I was at 0.0138. . .feels good to be back down). On 50 mg, it has been a slow plod to get there.
But. . most importantly, in response to your post. . .before you restart Sprycel, you MUST be sure that the PE is completely resolved. I was off meds for over a month after having mine drained. If you restart too soon, the fluid will simply build back up. Be sure a radiologist reads the x-ray. Also. . .in addition, it's nice to actually have the pictures so that you know what a PE looks like. I requested a copy of the x-rays, so the hospital put the pics on a disc. My PCP had films which I checked out and took home. I put them up in a window and took pics with my phone. I'm probably more well-versed on what a PE looks like than my PCP and my oncologist. Whenever I get an x-ray, I ask to see them. Perhaps that's unusual, but the doc never says, "no."
Good luck, and I hope you can reduce dosage. Also. . .if you do end up having the PE drained, it's not too painful, except when it gets toward the end of the process. . .or maybe mine was because my lung had partially collapsed. Anyway. . .if it starts to hurt, tell them and they can turn the valve to stop the flow of fluid, give you some time to catch your breath, and then keep going. Also. . .maybe I'm just weird. . .but I thought it was fun to actually watch the stuff drain out into the bottle(s). Have them put the bottles where you can see them. Unless it would gross you out.