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Aspiration Pneumonia and Possible Second Primary Cancer


IrishAuburn485

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Hi all,

I was just wondering if anyone had had any experience with aspiration pneumonia with suspected vocal cord issue (likely lesion or paralysis) that has led to worsened pneumonatic conditions.  How was your prognosis? What was the course of treatment. The onc has already told us that if it is a cancerous lesion, it is most likely a secondary primary cancer since its quite rare for NSCLC to spread to the larynx. Any words of wisdom, experience or advice would be apprecaited.

Maigan

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Maigan,

Unfortunately, yes I did have a very disturbing experience with aspiration pneumonia. In my case, my epiglottis, a flap of cartilage that is supposed to depress and seal the trachea when swallowing.  Unfortunately, mine was not depressing or sealing and the cause was temporary paralysis from excessive coughing while recovering from a severe episode of pneumonia.  I did not have a tumor or lesion in the epiglottis or in my vocal chords but my course of treatment is explained by a blog I wrote sometime ago.

Here is the blog.  The treatment was unusual because it was vocal chord exercises administered by a Speech Pathologist.

I've also read it is rare for NSCLC to spread to the larynx so let us hope the aspiration pneumonia has a cause other than cancer.

Stay the course.

Tom

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Hi Maigan,

Aspiration, which can lead to pneumonia, is often (maybe mostly) caused by   weakness somewhere in the swallowing apparatus. These issues are usually treated by speech pathologists. I don't know of anyone who has had aspiration due to cancer, but i do know people who've had it due to neurological problems (temporary or permanent).  Alcohol and drugs, including anesthesia and prescribed sedatives can interfere with swallowing. 

Briddget

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Thank you @Tom Galli and @BridgetO! The ENT came in yesterday and unfortunately Mom's left vocal cord is paralyzed. They aren't allowing her to eat because at this point her left lung is completely full of pneumonia and the ENT seems to feel that Mom's paralysis is most likely a permanent issue caused by prior nerve damage done by the tumor in her left lung infringing on the nerve. It is POSSIBLE that over time as, she continues treatment, that it cut just be being "put to sleep" by a tumor that will eventually shrink and relieve the nerve. Mom's been very hoarse since we started her most recent chemo treatments at the end of November.  Onc originally thought it might have been  fungal situation but her last PET scan showed reduction in the cancer but a spot that lit up in her throat. She was suppose to see the ENT on an outpatient basis last Monday to look at it but then she was admitted to the hospital with the pneumonia so that never happened. Her pneumonia has worsened since she's been here so even though she passed the barium swallow test for everything but thin liquids, the differential diagnosis is that she could still be aspirating other things that are worsening her pneumonia. They have decided to do a feeding tube to treat so hopefully they can improve the pneumonia and get her home to continue with treatment for the lung cancer. This hospital stay has been quite a roller coaster of a journey that started with her coming to the ER with a fever after treatments. A week and a half later and here we are.... 

Also @Tom Galli, you are correct, its very uncommon for NSCLC to spread to the larynx and if something is found there, it's usually a second primary cancer. Fortunately, there the ENT confirmed that there is no tumor on the vocal chords or in the area that they were evaluating for the PET so that's a piece of news. 

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@BridgetO this has definitely been the most challenging of times. Doing my best as a caregiver to make all the right choices and help my Mom through this.  I feel so terrible for my Mom as she came in for a fever and is going home with a feeding tube ultimately.  It's been a really long week and a half for all of us, but I'm not the one who has to go through all the procedures so I really feel the worst for Mom. 

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