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pneumonitis?????

debbien
0 Recommendations

my husband has had 1/3 of his r lung removed after dx of stage 3 nsclc. he had chemo and then 5 weeks radiation. he didnt seem to have side effects from the radiation, but now 3 months later, he got a common cold and he feels like a truck is parked on his chest. he went to his primary dr and they said he was ok. they gave him an antihistimine for the cough. well, the heavy feeling hasnt gone away and its been 2 1/2 weeks. he has no additional shortness of breath. he has had pnemonia 4 x's before and would be familiar with those symptons. we are aware of the radiation induced pneumonitis and wonder if that would feel like this, or would it feel like regular pnemonia? he feels pretty depressed thinking this may be permanant

Explore topics in this discussion:

Cancer Combivent Radiation therapy Common cold Pneumonia Chemotherapy Tarceva Prednisone Supplemental oxygen Taxol Avastin Physical therapy Breast cancer Azathioprine Pain Lung cancer

12 replies

LTLCS

I had radiation pneumonitis 2-/12 months after I completed my treatments. I had SOB (shortness of breath) and I was very very tired all the time, I also felt a heaviness or tightness of my chest as well. Your husband's PCP is not who he should be seeing. Either call the Radiation Onc or get a Pulmonologist if you don't have one. This is nothing to play with. I was on prednizone for 8 weeks. This is what they give me for radiation pneumonits.

Best wishes for you & your hubby.
Connie

cynthialcsw

After chest radiation I planned a lovely beach vacation with my family. Low and behold my chest started feeling full and I was coughing ALL the time. Finally went to the Sarasota ER b/c I though I had a reocurrance of lung tumors. They said it was pneumonitis from the radiation. I was relieved and the meds and codiene cough syrup helped. I was unaware that this could be an after effect of lung radiation. Cynthia from MO.

cards7up

I agree with Connie, when dealing with something like this your PCP is not the one to see. You need to see the specialist. Good luck and take care, JC

easterbaby

It is unreal how onc/radiologists differ and even the pulmonologist. The ONC told my sister it had to be scarring but she should not have the pain. She went back to the lung doctor who told her it pneumonitis and gave her a steroid inhaler to try for 2 months but was not very hopeful it would work. Well, it hasn't. In the meantime she went to her PCP who also told her she shouldn't be hurting. The ONC finally referred her to pain management and physical therapy. The massage therapist says my sister has lymphodema and is working to move the blocked fluid towards good lymphnodes so the fluid can drain. She told my sister she sees this very little and it is usually with breast cancer patients. I will have quite a few questions when I accompany her to get her results.

LTLCS

Dear easterbaby,

My Pulm Doc did a chest X-ray to determine if I had pneumonitis. But he did say, he was pretty sure that's what it was anyway. It's been 14 years that I had it but, I don't think a Steroid Enhaler is what will work for pneumonitis, even today. I was on Prednizone PILLS! And I was watched closely by my Pulm Doc. If I were your sister I would make damn sure ALL the doctor's are on the same page. I wouldn't settle for 3 or 4 different diagnosis. She can also see a Radiation Onc. (is that the ONC doc your talking about)? That's who she should see if the Pulm Doc doesn't treat this correctly.

It might be worth asking Dr. West on www.cancergrace.com what he or the other doc's there think.

Your a good sister to accompany her to her appointment. Sending you both good wishes and positive vibes.

Hugs,
Connie

LTLCS

P.S. Dr West's website is www.cancergrace.org
The one I posted above is wrong.

Good luck. Hope she feels better soon.

easterbaby

Thanks Connie. I will ask him.

The pulm looked at her last scan from the radiologist. He said she had fibrosis and pneumonitis. What I am confused about is that I thought they would gave her an antibiotic.

The radiologist and the onc are two separate drs but they are at the same clinic.

Esther says the the pain is still there but different than originally felt. It is still pretty painful but not as painful as it was at first.

The onc did put her on predisone for 6 days when she first told him about the pain which he said had to be the scarring and some inflammation. She said it didn't help.

I can have her call the pulmonologist and ask for a referrel to a radiation onc once I found out if her radialogist is an onc or not.

She told me that if she had to go on Tarceva that she could not be able to handle the pain and the rash too. I am really worried. But I will be asking questions come Wed.

I also know that everyone's insurance is different but she has been on avastin as maintenance and only sees the dr once every 3 months even though she has the avastin once a month. Her copay is $40. We spoke to another lung cancer patient in our area that goes to the same name clinic but at another location and she advised she saw the dr each time. Esther's dr office says the $40 copay is level 1 fee and if you see the dr it is more plus she sees a nurse each time. Well, the nurse is the infusion nurse and not the dr nurse. We asked to see her for a few minutes on Esther's last avastin and they were busy. I wrote a note to give the nurse and one question was who refers her to pain management - onc-pulm- or the pcp. The onc nurse called that same day and told her they were setting her with pain managment and physical therapy. I am afraid because I don't want her to lose her battle because of this dang pain.

Thank you for your info.

Von

I too had pneumonitis, diagnosed by oncologist. No antibiotics are givin because it is not a bacterial pneumonia, it is inflamation from radiation damage. I started on 60 mg prednisone, combivent inhaler, and q var a steriod inhaler. I was on prednisone for 11 months, weaning down 5mg every 4 weeks. This can be fatal and should be treated aggressivly. It has been 3 months since using prednisone but I stll have to use inhaler every now and then. Find out what is really going on. peace,love,joy, Von

Von

Debbien, PS I was taken off the Tarceva while on prednisone, it will suppress your immune system. V

gpawelski

For patients that had chemo or radiation, infections are the curse of the rest of their lives (a.k.a. "late toxicities develop only in people who survive"). You need to nip these infections in the bud ASAP.

One needed specialist to treat your side effect symptoms is a Pulmonary Specialist for radiation pneumonitis. This is not what oncologists do. They don't know how!

Radiation pneumonitis is a lung inflammation infection. One of the side effects of chest radiation therapy involves the lungs. When high-energy rays are used to damage cancer cells and stop them from growing and dividing again, it is inevitable that normal cells are also affected.

Especially after radiation treatments within the chest or the breast, the lungs may become inflamed (radiation pneumonitis). If radiation pneumonitis persists, it can lead to scarring of the lungs (radiation fibrosis). Longer term side effects of scarring is radiation necrosis.

When radiation exceeds tolerated doses, inflammation of the lung can be seen from one to three months after treatment. The process can be lethel when both lungs are involved or if threshold doses of chemotherapy (if used) have been exceeded (particularly Taxol). Recovery from the acute phase usually occurs and the second phase follows almost immediately.

Taxol appears to increase the risk of lung inflammation and researchers have reported in the Journal of the National Cancer Institute suggesting using Taxol with caution. It is sometimes used along with radiation treatments since it is thought the drug might enhance the radiation effects. The combination may cause more problems than it solves, like radiation pneumonitis.

Eventually, progression to the late fibrotic stage could occur. Radiation pneumonitis "should be prevented." Corticosteroids can aid in recovery from acute pneumonitis. Antibiotics for infection and supplemental oxygen may be needed. Other agents that have been used for treatment of radiation pneumonitis include azathioprine and cyclosporinA.

Because radiation pneumonitis is thought to occur as a result of excessive generation of free radicals in healthy tissue after radiation therapy, radiation-induced pneumonitis can also be treated with antioxidants.

Amifostine, an inorganic thiophosphate prodrug of free thiol, may act as a free radical scavenger, and has demonstrated myeloprotective, nephroprotective, and neuroprotective properties when administered to patients before a variety of chemotherapy regimens.

debbien

thanks everyone. casey says his chest pain is almost gone now. he wants to take a wait and see approach. i just like to give him informed choices and that what i get here

Von

I guess this is one of those ask 20 people, get 20 different answers...The prednisone worked great, I did not have infection, only inflamation and damage. Its not to our benefit to take antibiotics if not really needed. Glad to hear he is doin better...peace, love and joy, Von

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