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Pneumonitis


SharKats

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Had anyone here developed pneumonitis within a coupld days of the final treatment? If so, how was it treated? I was so happt to finish the 25 treatments and I've felt horrible ever since. My onc wants me to go back for another chest x-ray altho I just had one a 9 days ago. I am so short of breath I'm wondering if oxygen might make things easier. Would anyone mind sharing their radiation-induced pneumonitis story?

I'm sorry if this is redundant and this is somewhere back in older threads. I just don't spend much time on-line since the radiation..

Thank you!

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This might not be exactly the same but hubby did get pneumonia a little while after radiation. In his case I believe it was the chemo that lowered his resistance.

Anyway - they gave him 7 days of Levaquin, a powerful antibiotic, by mouth. More serious cases can have IV antibiotics if needed. It cleared it up well though it took the whole 7 days. He has 3 x-rays in 3 weeks, one taken before, another when diagnosed, and then a third to make sure it cleared up.

By the way, the Radiation worked great on hubby's tumor. The radiation discomfort passed within 2 weeks of stopping the radiation.

Keep us posted. Margaret

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Sharkats,

My dad did develop pneumonitis during treatment..Please beware because my dads radiologists insisted there was no way he could have it because he was sure symptoms only appeared months after therapy..My dad stopped treatment on his own, if it was up to his radiologist he would have still gone, even after complaining about severe shortness of breath.

After walking out on one of his appointments he went to see his pulm and after an xray it was confirmed radiation pneumonitis..Dads pulm told him that it as a good thing he walked out of that appt.. I dont want to scare you, but I couldnt ignore this, and so you know pneumonitis can get better without any permanent damage, my dads case was just very unfortunate to say the least and the fault of a doctor who wasnt listening to him..Hope this helps

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I had radiation pneumonitis develop after treatment, it seemed to set in about 1-2 months after ending treatment. I had a constant "itching" in my chest and every single time I took a deep breath, I ended up in a coughing fit. I had to take steroids for a few months to get rid of the horrible cough, it also eased the itching.

Unfortunately, if radiation pnuemonitus is not treated quickly, it can lead to radiation fibrosis, which is perminent damage/scar tissue in the lungs....which I apparently have a touch of, per my last CT Scan.

I would definetely follow up with your doctor or Pulminologist -- my pulminologist was the one who prescribed the steroids.

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Thank you so much for your responses. My onc wants me to now have catcan w/contrast and another regular chest x=-ray. She did ask me on my first visit about feeling so bad if I wanted to go to the hospital. Of course I said no.

I have finished the Levaquin and the steriods but I don't see any improvement. I had dreaded having radiation = but....................

I'm worried about the fibrosus. All the info I've read said it developed weeks sometimes months after. Mine visited in 3 days.

Thanks again, this is very nerve-wracking and I know all of you know that feeling.

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pirfenidone is a drug in clinical trials

http://www.pulmonaryfibrosis.org/research.htm

Ask the Experts about Lung Cancer

from Medscape Hematology-Oncology

Treatment for Radiation Pneumonitis

Question

A 68-year-old woman was diagnosed with stage IIIA lung adenocarcinoma 2.5 years ago. She underwent tumor resection, radiation, and chemotherapy. She is doing well, except for a constant cough, which is attributed to postradiation pneumonitis. Prednisone 10 mg alleviates the cough, but the side effects are prohibitive. Do you have any other suggestions?

Response from Virna Ignacio Almuete, RPh

Clinical Instructor, University of Maryland School of Pharmacy, and Clinical Pharmacist, Division of Oncology, Johns Hopkins Hospital, Baltimore, Maryland

Radiation pneumonitis is an inflammatory process affecting the lungs following radiation therapy. This condition develops in 5% to 15% of lung cancer patients receiving high-dose external-beam radiation. Factors that affect the risk of damage to lung tissue 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.

The pathophysiology of radiation pneumonitis is described as 2 distinct mechanisms. The first is classical radiation pneumonitis. Injury to capillary endothelial and epithelial cells of the lung from the radiation results in an acute alveolitis. The inflammatory process leads to pulmonary fibrosis and is confined to the field of radiation. The second mechanism is sporadic radiation pneumonitis or an "out-of-field" response. This is thought to be an immunologically mediated process resulting in bilateral lymphocytic alveolitis.

Although pathologic changes in lung tissue occur in the initial 24-48 hours after radiation, those changes are undetectable clinically and radiologically. Symptoms of acute radiation pneumonitis develop 1-6 months after completion of therapy. Symptoms can include dyspnea, cough, pinkish-tinged sputum, and fever. Severe reactions can result in dyspnea, pleuritic chest pain, hemoptysis, acute respiratory distress, and death. The characteristic feature of radiation pneumonitis is a diffuse infiltrate corresponding to a previous radiation treatment field.

Corticosteroids are commonly used for the treatment of radiation pneumonitis. Prednisone is started at 1 mg/kg/day upon diagnosis and is continued for several weeks and then tapered slowly. Other agents that have been used for treatment of radiation pneumonitis include azathioprine and cyclosporin A.

Posted 01/06/2003

Pentoxifylline with vitamin E has recently been shown to cause

regression of RT-induced fibrosis.

http://www.cancernetwork.com/handbook/pdf/46radtox.pdf

http://essiac-info.org/BobK/article1.html

http://www.lef.org/protocols/prtcl-025a.shtml

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Yes I had it. I finished my radiation and about 2-3 months later developed shortness of breath - so short that when I just walked through the house I panted as if I'd run 5 miles (stairs were a real challenge and really put anyone around me on edge!!). Anyway pheumonitis was diagnosed and I was put on steroids which did nothing to help but made me sweat profusely. That lasted about 8-10 weeks and I came off the steroids, my onc told me that this delightful side effect could a) be cured with steroids, B) go away on it's own evenutally, c) stay forever. All in all it was going to be a crap shoot. Fortunately I came under catagory b and went off the steroids and it did go away.....it took a few months but gradually I could do more without it sounding that this was to be my last breath. I also coughed sometimes (the only time I coughed through this whole cancer ordeal) but only after exertion - like walking at a normal pace.

I hope you fall under a or b and it goes on it's way.

Geri

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