What is radiation pneumonitis and how is it treated?
What Is Radiation Pneumonitis and How Is It Treated? 1 These symptoms are very similar to those of both pneumonia and lung cancer. 2 Radiation therapy works by killing or damaging cancerous cells. 3 Some people are more likely than others to develop radiation pneumonitis...
Is radiation pneumonitis similar to lung cancer?
These symptoms are very similar to those of both pneumonia and lung cancer. In addition, radiation therapy can cause similar side effects, even in people who don’t develop radiation pneumonitis. As a result, many people ignore these symptoms and don’t get treatment.
What causes pneumonitis after radiation therapy?
Some people who undergo radiation therapy to the chest, such as for breast or lung cancer, may develop pneumonitis. Pneumonitis also can occur after whole-body radiation therapy, which is needed to prepare a person for a bone marrow transplant. Some occupations and hobbies carry higher risks of pneumonitis, including: Farming.
How long does it take for radiation pneumonitis to develop?
However, anyone receiving radiation therapy to the chest can develop it. While it tends to happen about 4 to 12 weeks after radiation treatment, it can develop as early as 1 week after treatment. In other cases, it develops very slowly over the course of several months. What are the symptoms? The main symptoms of radiation pneumonitis include:
What tests can be done to confirm radiation pneumonitis?
There is no specific diagnostic test to confirm radiation pneumonitis. Instead, your doctor will make a clinical diagnosis based on symptoms. The analysis might include the following: 6. Blood tests that look for signs of infection or inflammation in the blood, such as an increased white blood cell count.
How do you know if you have radiation pneumonitis?
Radiation Pneumonitis Symptoms. Radiation pneumonitis symptoms can be very similar to lung cancer symptoms or side effects from other cancer treatments, or they can be mistaken for an infection such as pneumonia. Thus, many people disregard or miss these common signs of RP: 1 . Dyspnea: Shortness of breath that is more pronounced ...
What is RP in a syringe?
Radiation pneumonitis (RP) is an inflammation of the lungs due to radiation therapy or stereotactic body radiotherapy (SBRT) for cancer. Radiation pneumonitis affects between 15% and 40% of people who undergo radiation therapy for lung cancer. 1 It may also develop in patients who undergo chest radiation for breast cancer, lymphomas, ...
What are the risks of radiation?
Several factors, however, can put you at risk for complications: 4 1 Chemoradiation: Receiving chemotherapy concurrently (at the same time) as radiation therapy raises the likelihood that you'll develop radiation pneumonitis. 2 Gender: The risk of RP is estimated to be 15% in women versus 4% in men. 3 Age: Lung cancer patients over age 65 are more susceptible to radiation pneumonitis. 4 Tumor location: Several studies have shown that RP is more common when radiation is used on lower lung lobes versus higher lobes. 5 Lung function: People who have other lung diseases, such as COPD, are at an increased risk. 6 Type of chemotherapy drugs (if applicable): Paraplatin (carboplatin) and Taxol (paclitaxel) are more likely to lead to this specific pulmonary complication.
How long does it take for a person to recover from radiation?
These symptoms may appear as little as a month after radiation or may not develop until a year later, but most cases are diagnosed within eight months of treatment. 1 . Often, the symptoms are mild enough for people to tolerate and recover with no need for additional medical treatment.
Is radiation pneumonitis deadly?
While radiation pneumonitis can sometimes lead to serious respiratory distress, in the vast majority of cases, it is not a deadly condition. The risk of dying from RP is less than 2%. 1
Does biaxin help with lung cancer?
Researchers are looking for ways to reduce the risk of radiation pneumonitis among people going through radiation for lung cancer. For those who will be having SBRT, a positive development has been the use of the antibiotic Biaxin (clarithromycin), which seems to significantly reduce the severity of RP and may actually prevent it from developing.
What are the factors that increase the risk of radiation pneumonitis?
Treatment factors that increase the risk of radiation pneumonitis: High dosage or duration of treatment. Larger amount of lung tissue exposed to radiation. Previous radiation therapy or lung injury. Other recent or current treatments, such as chemotherapy. Other factors that may increase the chances of radiation pneumonitis:
What is the goal of radiation treatment?
When caught early the goal of treatment is to stop inflammation before it causes damage. The course of treatment depends on the severity of the radiation pneumonitis. Prompt treatment may lead to a full recovery in most people.
Why is the lungs sensitive to radiation?
Lung tissue is sensitive to irritants like radiation. Sometimes after exposure to high doses of radiation the tissue becomes inflamed. Inflamed tissue swells and produces extra fluid which blocks gas exchange between the lungs and the bloodstream. The body will have less oxygen available in the blood.
Why is radiation important?
The earlier symptoms are recognized and treated, the better the outcomes. It is important to monitor any side effects from radiation therapy.
Can radiation cause alveoli to be inflamed?
Radiation pneumonitis causes inflammation in these alveoli. The inflammation can decrease the amount of oxygen that enters your body. If it remains untreated, pneumonitis can also lead to permanent tissue damage.
Does radiation pneumonitis cause shortness of breath?
Some people with radiation pneumonitis do not have apparent symptoms. In those that have them, the most common is shortness of breath with activity or rest, which worsens with time.
Radiotherapy-induced adverse events
Radiation pneumonitis resembles interstitial pneumonitis. An acute inflammatory reaction, an alveolar component, and vascular lesions are observed. Vascular endothelial cells and type II pneumocytes are postulated as the major target cells. The latter line the alveolar walls, produce surfactant factor, and are stem cells of type I pneumocytes.
The Lung, Pleura, and Thymus
Ritsuko Komaki, ... James D. Cox, in Radiation Oncology (Ninth Edition), 2010
Acute and Late Toxicities of Thoracic Radiotherapy
José Belderbos, ... Lawrence B. Marks, in IASLC Thoracic Oncology (Second Edition), 2018
Adjuvant and Neoadjuvant Radiation Therapy for Lung Cancer
Richard D. Pezner MD, in Medical Management of the Thoracic Surgery Patient, 2010
RADIATION-INDUCED PULMONARY DISEASE
Murine models of RP strongly suggest that injury to pulmonary capillary endothelial cells and type II pneumocytes mediates the pathogenesis of RP ( Figure 2) ( see ENDOTHELIAL CELLS AND ENDOTHELIUM ).
Diagnosis and Management of Treatment-Related Pulmonary Complications
Jennifer D. Possick MD, in Lung Cancer: A Practical Approach to Evidence-Based Clinical Evaluation and Management, 2018
Lung and Pleura
Alexander Craig MackinnonJr., Aliya N. Husain, in Differential Diagnosis in Surgical Pathology (Second Edition), 2010
What is the term for pneumonia that is developed while you are in the hospital?
Certain types of pneumonia may include: Community acquired pneumonia-, which means that you developed pneumonia while you were outside of the hospital, or out in the community. This type of pneumonia will commonly follow a viral illness. Gram-positive organisms cause many community-acquired pneumonias.
What causes pneumonia?
Causes of Pneumonia: Bacterial, viral or atypical pneumonia - this refers to the virus, organism or "bug" that caused your pneumonia. Certain antibiotics will treat specific bacteria. Your healthcare provider will take this into consideration before they prescribe an antibiotic to treat you.
What is the term for an infection that causes your lungs to be inflamed?
Infectious pneumonitis is when an infection caused your lungs to be inflamed. This is commonly known as pneumonia. Treatment related pneumonitis is an inflammation of your lungs following chemotherapy or radiation therapy. Treatment related pneumonitis can cause you to have long-term side effects.
What are the risk factors for pneumonia?
You are at risk (called risk factors) for developing pneumonia if: You have an altered immune system following chemotherapy or radiation therapy, or long-term steroid use. If you are inactive, and perhaps ill with a virus. If you have an altered immune system from AIDS or HIV.
What is the name of the infection that you may have gotten while you were in the hospital?
Nosocomial pneumonia- this is the name for a pneumonia you may have gotten while you were in the hospital. Different types of bacteria are responsible for these infections, versus the community-acquired pneumonia. Gram-negative organisms cause most community-acquired pneumonias.
How do you know if you have pneumonia?
Symptoms of Pneumonia Include: You may notice chest "t ightness "; difficulties getting a "good breath", feelings of breathlessness, or that you are hungry for air. You may have chest pain on the side of your infection. You may notice that you are "wheezing", when you breathe. You may have fever, shaking chills, or a headache.
Can a gram positive cause pneumonia?
But sometimes, your body is unable to fight them. If you have a bacterial pneumonia - Certain bacterium, called gram positive and gram-negative bacteria - can cause your pneumonia. Gram-positive - some common gram-positive organisms that cause pneumonia include staphylococcus aureus and streptococcus.
Why is pneumonia considered a type of pneumonitis?
Technically, pneumonia is a type of pneumonitis because the infection causes inflammation. Pneumonitis, however, is usually used by doctors to refer to noninfectious causes of lung inflammation. Common causes of pneumonitis include airborne irritants at your job or from your hobbies.
What causes pneumonitis?
Pneumonitis causes may include: 1 Drugs. A variety of drugs can cause pneumonitis, including some antibiotics, several types of chemotherapy drugs and medications that keep your heartbeat regular. An overdose of aspirin can cause pneumonitis. 2 Molds and bacteria. Repeated exposure to some molds and bacteria can cause the lungs to become inflamed. Specific varieties of mold-related pneumonitis have received nicknames, such as "farmer's lung" or "hot tub lung." 3 Birds. Exposure to feathers or bird excrement is a common cause of pneumonitis. 4 Radiation treatments. Some people who undergo radiation therapy to the chest, such as for breast or lung cancer, may develop pneumonitis. Pneumonitis also can occur after whole-body radiation therapy, which is needed to prepare a person for a bone marrow transplant.
What causes pneumonitis in farm workers?
Farming. Many types of farming operations expose workers to aerosolized mists and pesticides. Inhaling airborne particles from moldy hay is one of the most common causes of occupational pneumonitis. Mold particles also can be inhaled during harvests of grain and hay. Bird handling.
What causes lungs to become inflamed?
Molds and bacteria. Repeated exposure to some molds and bacteria can cause the lungs to become inflamed. Specific varieties of mold-related pneumonitis have received nicknames, such as "farmer's lung" or "hot tub lung.". Birds. Exposure to feathers or bird excrement is a common cause of pneumonitis. Radiation treatments.
What are the symptoms of chronic pneumonitis?
Signs and symptoms of chronic pneumonitis include: Shortness of breath. Cough.
What is the most common symptom of pneumonitis?
Difficulty breathing — often accompanied by a dry (nonproductive) cough — is the most common symptom of pneumonitis. Specialized tests are necessary to make a diagnosis. Treatment focuses on avoiding irritants and reducing inflammation.
Can pneumonitis cause lung damage?
Pneumonitis that goes unnoticed or untreated can cause irreversible lung damage. In normal lungs, the air sacs stretch and relax with each breath. Chronic inflammation of the thin tissue lining each air sac causes scarring and makes the sacs less flexible. They become stiff like a dried sponge.
How much roentgen is used for pneumonia?
The use of Roentgen rays with a dose of 100–150 Roentgen in the treatment of pneumonia in children has been studied long time ago. The results indicated that the use of this radiation in low doses can be effective in the treatment of this disease.#N#Reference Oppenheimer#N#17 The application of ionising radiation in the treatment of pneumonia has been studied since the beginning of the last century. The results of this study showed that the use of low doses was able to decrease mortality in these patients like other methods including serum therapy and drug treatments. The use of low doses with a mean of 50 Roentgen has been effective in the treatment of most patients suffering from pneumonia.#N#Reference Calabrese and Dhawan#N#18 In some countries, such as Germany, low-dose radiotherapy is applied as an acceptable remedy method for the treatment of nonmalignant diseases such as inflammatory, degenerative, hyperproliferative, functional and vascular diseases.#N#Reference Seegenschmiedt, Micke and Willich#N#19
What is the disease that affects the respiratory system?
The Coronavirus disease 2019 (COVID-19) is spreading rapidly throughout the world. Lung is the primary organ which the COVID-19 virus affects and leads to pneumonia, an acute respiratory distress syndrome. COVID-19 infects the lower respiratory system, and the lung’s response to this infection is recruiting macrophages and monocytes leading to inflammation, this response causes widespread damage to the lung’s airways.
How does radiation affect the immune system?
Animal studies show that low-dose irradiation (more than 1 Gy) may lead to immunosuppression . Doses above 1 Gy result in deficiency of haematopoietic stem cells, accelerated cell cycling of bone marrow precursors, decreased cell viability of mature blood cells and suppression of blood leukocyte levels.#N#Reference Yagunov, Tokalov, Chukhlovin and Afanassiev#N#12,#N#Reference Seed, Inal and Dobson#N#13 Blood samples of radiology workers ranging from 21 to 57 years who are exposed to long-term low ‘dose reveal that some immunological parameters such as levels of T lymphocytes, IgA, IgG and IgM are decreased.#N#Reference Godekmerdan, Ozden, Ayar, Gursu, Ozan and Serhatlioglu#N#14
Does radiation affect the lungs?
The anti-inflammatory effect of radiation on the lungs is through modulation of cytokine and adhesion molecule expression on activated endothelial cells and leukocytes and on nitric oxide (NO) production and oxidative burst in activated macrophages and native granulocytes. The highest efficiency was reported at doses of 0.3–0.7 Gy.#N#Reference Rödel, Keilholz, Herrmann, Sauer and Hildebrandt#N#6
Radiation Pneumonitis Symptoms
- Radiation pneumonitis symptoms can be very similar to lung cancer symptoms or side effects from other cancer treatments, or they can be mistaken for an infection such as pneumonia. Thus, many people disregard or miss these common signs of RP:1 1. Dyspnea:Shortness of breath that is more pronounced with physical exercise 2. Hypoxemia:Low oxygen levels in your blood, …
Cause
- While radiation can stop your cancer by killing malignant cells, it can also damage healthy cells. Specifically, radiation causes the loss of cells that secrete pulmonary surfactant, a chemical that keeps the alveoli, or lung's air sacs, open so that they can fill with air and efficiently regulate breathing.3 A lack of surfactant often results in respiratory distress. You may already have famili…
Diagnosis
- There is no specific diagnostic test to confirm radiation pneumonitis. Instead, your healthcare provider will make a clinical diagnosis based on symptoms. The analysis might include the following:6 1. Blood tests that look for signs of infection or inflammation in the blood, such as an increased white blood cell count 2. Pulmonary function tests (PFTs)to assess reduced lung volu…
Treatment
- Radiation pneumonitis treatment is aimed at decreasing the inflammation. Corticosteroids, such as prednisone, are the main course of treatment.1 Typically, your healthcare provider will treat you with 60 milligrams (mg) to 100 mg per day for two weeks and then lower the dosage, tapering you off the medication over three to 12 weeks. Researchers hav...
Prognosis
- While radiation pneumonitis can sometimes lead to serious respiratory distress, in the vast majority of cases, it is not a deadly condition. The risk of dying from RP is less than 2%.1 Thus, with proper treatment, you should be able to overcome radiation pneumonitis. However, if it goes untreated, RP can lead to pulmonary fibrosis, scarring of the lungs.7 This condition, which ca…
Prevention
- Researchers are looking for ways to reduce the risk of radiation pneumonitis among people going through radiation for lung cancer. For those who will be having SBRT, a positive development has been the use of the antibiotic Biaxin (clarithromycin), which seems to significantly reduce the severity of RP and may actually prevent it from developing. Another area being researched is th…
A Word from Verywell
- Radiation pneumonitis is very common in people who are treated for cancers such as lung cancer and breast cancer. Thankfully, with treatment, the condition often resolves without going on to cause life-threatening problems. The most important thing you can do is be aware of the possible symptoms and talk to your healthcare provider if you experience any of them.
Definition
- Radiation pneumonitis is an inflammation of the lung tissue. Radiation pneumonitis often appears between 6 and 24 weeks after radiation therapy. Air moves through the airways into air sacs of the lungs called alveoli. The alveoli have several blood vessels that allow for gas exchange between the lungs and blood. Oxygen can pass from the lungs to th...
Causes
- In most cases, radiation pneumonitis is caused by radiation therapy to the lungs. Lung tissue is sensitive to irritants like radiation. Sometimes after exposure to high doses of radiation the tissue becomes inflamed. Inflamed tissue swells and produces extra fluid which blocks gas exchange between the lungs and the bloodstream. The body will have less oxygen available in the blood. I…
Risk Factors
- Radiation pneumonitis is most common in people who have radiation therapy for lung cancer. Treatment factors that increase the risk of radiation pneumonitis: 1. High dosage or duration of treatment 2. Larger amount of lung tissue exposed to radiation 3. Previous radiation therapy or lung injury 4. Other recent or current treatments, such as chemotherapy Other factors that may i…
Symptoms
- Some people with radiation pneumonitis do not have apparent symptoms. In those that have them, the most common is shortness of breath with activity or rest, which worsens with time. Radiation pneumonitis may also cause: 1. Persistent dry cough, which may range from mild to severe 2. Chest pain 3. Increasing amounts of sputum, which may or not have blood 4. Fever 5. …
Diagnosis
- The doctor will ask about any symptoms and medical history including recent treatment. A physical exam will be done including listening to the lungs. Symptoms of radiation pneumonitis are similar to many other lung disorders. It is generally diagnosed by eliminating other causes of your symptoms. Tests may include: 1. Blood tests—to look for signs of infection or imbalance in bloo…
Treatment
- When caught early the goal of treatment is to stop inflammation before it causes damage. The course of treatment depends on the severity of the radiation pneumonitis. Prompt treatment may lead to a full recovery in most people. Radiation pneumonitis is treated with: 1. Corticosteroids to reduce lung inflammation 2. Medications to suppress the immune system Other medication or m…
Prevention
- Radiation is carefully measured to deliver the least amount of radiation to the smallest area of tissue while being effective. The earlier symptoms are recognized and treated, the better the outcomes. It is important to monitor any side effects from radiation therapy.