Radiation-induced pneumonitis

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My husband recently dodged a bullet. Last month he was diagnosed with "severe sepsis" and "septic shock" and "pneumonia" and "acute respiratory failure," etc. He was admitted to ICU and was on mechanical ventilation for 5 days. RADIATION-INDUCED PNEUMONITIS was the true diagnosis, according to the oncologist, but this language doesn't appear anywhere in hospital records. 

Symptoms were very subtle. It's important for EC patients to know about this complication. Pneumonitis is more common among lung cancer patients. 

In December 2017, ny husband, age 71, was diagnosed with 5 cm adenocarcinoma mass at the GE junction, stage T3N0M0. Jan-Feb 2018, he had 6 weekly carboplatin/taxol infusions. Original plan was 28 doses of IMRT but the radiation oncologist suggested they could "boost" intensity during final week. He would also increase the number of doses by 2 (from 28 to 30). This plan would (supposedly) give my husband the option of avoiding surgery. On Monday, President's Day (2/19) my husband had to get extra hydration therapy (+ 4 mg dexamethasone) because he was extremely weak. Esophagitis was extremely painful at that time. He could barely swallow smoothies. On Tuesday, the radiation oncologist said not to worry. Pain would go away in a couple of weeks. On Wednesday morning, my husband's behavior was very strange. I called 911 but EMTs said verbal responses were "appropriate." There was no reason to take him to the hospital. But when they measured his pulse, it was 190 bpm. A few hours later, he was admitted to ICU for what appeared to be "atrial flutter" and "pneumonia." He was tested for every imaginable infectious disease. They administered numerous anti-microbial drugs (anti-fungal, bacterial, viral) for the next few days. His condition worsened and he was intubated on Thursday. Finally, they gave massive doses of steroids and he gradually improved. On Saturday 3/3, my husband was discharged from the hospital to a skilled nursing facility. Breathing and heart rate were normal but physically, he was extremely weak. He could barely turn himself over in bed. During 2 weeks at the SNF, my husband received excellent care including physical therapy and occupational therapy. He is much stronger now. He can walk easily and go to the toilet without assistance. He was weaned off steroids yesterday.

I am thrilled that my husband survived and is going home tomorrow! We have many challenges ahead. But we can rest and enjoy each other for awhile. 

 

Comments

  • paul61
    paul61 Member Posts: 1,391 Member
    edited March 2018 #2
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    Your poor guy has really been "through the eye of the needle"

    I am so sorry to hear the challenges your husband has been through. It sounds like, in an effort to avoid surgery, they pushed his treatment a bit too far. I assume there was a medical reason to avoid surgery?

    Of course, all of us that have had esophagectomy surgery were very frightened going into surgery but that still seems to be the “standard of care” in “curative” treatment of esophageal cancer. Although we have seen people here who for one reason or another have not followed chemotherapy and radiation therapy with surgery that are still in long term remission.

    I assume once your poor guy, regains some strength and regained some weight they will be scheduling a series of scans and potentially an endoscopy to assess the response to treatment.

    I am sure you both feel at this point, survival is a major victory.

    I hope he continues to improve and gain strength and the test results are good news. He certainly deserves a break.

    Best Regards,

    Paul Adams

    McCormick, South Carolina

    DX 10/2009 T2N1M0  Stage IIB - Ivor Lewis Surgery  12/3/2009
    Post Surgery Chemotherapy 2/2009 – 6/2009 Cisplatin, Epirubicin, 5 FU
    Eight Year Survivor

    Life may not be the party we hoped for, but while we are here we might as well dance!