Like many of us, other than Cancer I am fairly healthy.I've survived 11 months of surgery, chemo & Rad.So far so good-Except my breathing is getting progressively worse-It appears I have Rad.pneumonitis-An evolving "gift" from the radiation I really wish I had refused. 3 out of 3 docs said to "DO IT", Alas, another one of our choiceless treatment "options"....During Rad. my Rad. Onc. was my "best friend"-When treatment ended he wouldn't even see me,when I finally did pin him down, he blew me off & shoved an RX at me for steroids.I've seen 2 Pulmonoligists since-The last one finally admitting I have Rad. Pneumonitis.BUT the truth is they don't know how to treat it-6 months steroids & it could come back with a vengence. I am scared-My scans show it is "evolving". I guess they don't expect us to out -live our long term side effects.I read an article on post treatment side effects-The brainiac that wrote it "Urges survivors not to panic,stating that"Late toxicities develop only in people who survive." Wow, I am consoled...Any hopeful radiation pneumonitis stories out there? Thanks Betsy T.
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Radiation pneumonitis
- By BetsyT
- Posted March 17, 2008 at 11:47 am · 5 replies
- In Non-small cell lung cancer - General
- Shared with the public
Explore topics in this discussion:
Cancer Taxol Surgery Radiation therapy Chemotherapy Prednisone Supplemental oxygen Lung cancer
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- By gpawelski
- Posted March 17, 2008 at 1:03 pm
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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've got to nip these infections in the bud ASAP.
You have brought up a very good observation. You advised your oncologist about your problem, but they do not have any answers as they treat the cancer and leave all the side effects up to us or other means (family physician).
Some of the "other means" should be specialists to treat your side effect symptoms. A Physical Medicine and Rehabilitation Specialist for neuropathy, a Pulmonary Specialist for radiation pneumonitis, a Neurologist for leukoencephalopathy or worse, radiation-induced necrosis, etc. 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 occurs. Radiation pneumonitis "should be prevented." Corticosteroids can aid in recovery from acute pneumonitis. Antibiotics for infection and supplemental oxygen may be needed.
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.
Armed with all this information, the husband of a good high school friend of mine, is keeping that "one step ahead" of the side effects of his treatment (surgery and focal radiation) for stage 3 NSCLC, being able to enjoy his golf and other activities even through his seventies.
- By LTLCS
- Posted March 17, 2008 at 2:04 pm
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I had RP as well 12 + years ago. I was treated by my Pulm Doc and not by the Rad Onc. I was told that's the way it was done. I was put on Prednisone(spell) for 6 weeks. However, my RP started 2 to three months after I completed my treatments.
The Prednisone did the trick for me and I have never had any problems since.
I do know some people that have had problems with SOB or coughing down the road after they had Radiation treatments, and it has never gone away for them. But, for the most part they are doing well with the SOB and or coughing issues. Some of there problems they are told is radiation damage to there lung/lungs.
I was very SOB when I had the RP but mine did clear up after I took the Pred.
Good luck to you.
- By BetsyT
- Posted March 18, 2008 at 9:43 am
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To gpawelski & LTLCS,
Thank you for your informative responses. It looks like steroids is the way to go. I've been hoping it would "clear up" on it's own (steroids scare me). It's taking some getting adjusted to-My lungs were never a weak spot for me, no bronchitis,asthma, SOB, ever. Now everything settles in my lungs-And to LTLCS, have you been symptom free all these years? I would love to hear your story. Thanks again to both of you. Betsy T.
- By arielle
- Posted March 30, 2008 at 12:21 pm
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Hello,
I, too, would love to learn about a good long-term lung cancer survivor story.
Also, I am being treated for radiation pneumonitis. I had ratiation last August and three months ago I got a dry cough and SOB and inability to inhale deeply w/o cough. I was put on 20 mg. prednisone, which helped a lot, but sometimes when I try to taper down the dose, the cough returns. After three months on prednisone (and more weight gain than I care to admit) I am down to 5 mg. I hope to be done with this when I get off the steroids, but it's helpful to read that there's a chance I will always have everything settle in my lungs and get frequent infections. It is the badge of honor, I guess, to survive this nasty disease.
Do you think taking anti-oxidants help keep the RP at bay?
Thanks,
Arielle
- By BetsyT
- Posted March 31, 2008 at 9:34 am
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Hi Arielle,
This new site alerted me that I had a response to this post, although I think you were inquiring in general. I still haven't gotten on steroids as I fear it would be a temporary "fix". I am curious to hear if you have gotten any relief ---Once you finish steroids. My Pulm. Doctor said 6 months of heavy duty steroids to "try" to stop Rad. pneumon..... I think they are stabbing in the dark. Yeah,in the "War Against Cancer" they pull out all the stops,but where are we The-Walking - Wounded supposed to go from here? Call me ungrateful,but sometimes "simply being alive" just doesn't cut it. I feel like a second class citizen-"Let's just try one more experiment"...This is a raw deal,period. Best to you, Betsy T.
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