Ok, I am back again asking questions for my sis. She is taking the last of her hydrocodone and is on predisone inhaler to reduce inflammation. She says she is doing a little better. I will see her tomorrow and judge that as she was not convincing to me. THe onc said to give it about 2 months on the inhaler but he doubted it would work. Ok.
Wondered if anyone has ever heard of these treatments-
Amifostine (ethyol) Supposedly the drug scavenges free radicals and they are produced by radiation which can damage your normal cells.
Pentoxifylline and Vitamin E -- Pnetoxifyline heals your lung tissue from the damage of radiation. Vit E is used for scavenging reactive species.
Guess you would still need pain meds but my brain is just turning.
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treatment for radiation pneumonitis
- By easterbaby
- Posted September 17, 2009 at 10:09 pm · 6 replies
- In Non-small cell lung cancer - Stage IV
- Shared with the public
Explore topics in this discussion:
Azathioprine Cancer Taxol Chemotherapy Pain Pentoxifylline Radiation therapy Supplemental oxygen Fever
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- By gpawelski
- Posted September 17, 2009 at 11:01 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 all the 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. 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.
Unitl the new mellenium, the only treatment for patients with confirmed symptomatic whole brain radiation-induced necrosis was pentoxifylline or heparin therapy, and it was almost always unsuccessful. HBOT became a useful therapeutic option for patients with confirmed symptomatic radiation necrosis.
- By DailySurvivor
- Posted September 17, 2009 at 11:40 pm
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Dear gpawelski,
Thanks for posting all the info, which I find VERY interesting. Could you also tell me what the SYMPTOMS are of radiation pneumonitis?
- By gpawelski
- Posted September 18, 2009 at 12:07 am
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Radiation therapy is the use of x-rays to kill cancer cells (or any cells in the way). Care is needed because both cancer cells and normal cells are damage by the radiation. The cancer cells are more sensitive to the radiation and are less able to repair the damage. X-rays damage the DNA of the cells, preventing them from dividing and causing them to die. The most lethal damage by the radiation are splitting both sides of the DNA, double strand breakage. The x-rays themselves do not cause the damage. The x-rays react with the water and other compounds in the cell and generate "oxidative species," such as free radicals and peroxides, that then react with the DNA and causes the damage.
One Gray is equal to 100 rads. A typical course of 6,000 rads can also be expressed as 60 Gray (or 60 Gy). Just one fraction (daily treatment) of 180 rads is 1.8 Gray (1.8 Gy). A typical course of 33 treatments at 180 rads equals a total of 59.4 Gray. The total of 60 Gray is normally the lifetime limit that doctors are able to give their patients. Typically, they overshoot the bulk of a tumor (or an excised tumor) by 2 or even 3 cm in hope of radiating some of the infiltrating tentacles.
Symptoms of radiation pneumonitis are shortness of breath upon activity, cough and fever. Blood testing usually shows an abnormal white blood count and an elevated sedimentation rate, signs that inflammation may be present somewhere in the body, but not pointing specifically at the lungs.
Factors that affect the risk of damage to lung tissue by high-dose external-beam radiation include: the volume of lung included in the field of radiation, the total dose and the fraction of that dose, individual susceptibility to radiation, previous irradiation, low performance status, concomitant chemotherapy, and abrupt steroid withdrawal.
- By easterbaby
- Posted September 18, 2009 at 6:31 am
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Thank you for the info GP. I have printed it out and will give it to my sister.
I highlighted the nipping in the bud asap so she knows why I keep pushing her.
- By cards7up
- Posted September 18, 2009 at 8:07 am
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Here is a good article on it. Talks about what to take to help. Good luck and take care,JC
http://jco.ascopubs.org/cgi/content/full/23/34/8551
I also had another post here,but it disappeared.
- By gpawelski
- Posted September 18, 2009 at 8:47 am
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Thanks for the study link JC.
Sometimes medicine is seen as practicing with evidence-based medicine (EBM) but sometimes there is an art to it. One must be cautious that off label remedies are fully discussed with the patient and the doctor must not do any harm.
Antioxidants have been shown to prevent fibrosis and actually reverse it. Based on the published research, it appears that patients undergoing radiation procedures might derive therapeutic and protective benefits if they consumed the proper antiozidants before, during, and after therapy.
One example is a combination of pentoxifylline tablets (400 mcg, 3 times daily) and vitamin E (one 400mg capsule each day). Data indicate a therapeutic effect on radiation-induced fibrosis by the synergistic administration of pentoxifylline and vitamin E.
Pentoxifylline is a prescription drug that inhibits abnormal platelet aggregation and may allow more blood flow to the irradiated area (Gottlober et al 1996). The combination of pentoxifylline and vitamin E seems to promote a significant antifibrotic effect by reversing deep radiation-induced fibrosis (Lefaix et al 1999).
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