What is it?
Pneumonitis is inflammation of the lungs. It can be caused by breathing in a toxin or allergen but in oncology patients it can be caused by treatment of cancer with radiation or certain chemotherapies or where the tumor is. Pneumonitis can cause:
- shortness of breath
- a low level of oxygen in the body
- chest pain with breathing
Signs of pneumonitis caused by chemotherapy often start within days of getting it. Whether or not you get pneumonitis from radiation depends on the volume of lung tissue within the radiation fields. For example, breast irradiation often affects only a small area of lung tissue. Lung cancer treatment fields are often larger, making your risk of pneumonitis even greater. When patients are treated with radiation that affects lung tissue and also given chemotherapy it may increase the level of pneumonitis.
Pneumonitis often goes away within a few weeks. Pulmonary fibrosis can develop in the affected lung tissue as a late effect of radiation therapy. Pulmonary fibrosis is when the lungs become damaged, scarred and therefore stiff.
Prevention of pneumonitis is key. Chemotherapy and radiation should be given at the lowest but most effective doses so that harm to the lungs is minimal. The management of pneumonitis is aimed at controlling the symptoms.
- Oxygen therapy to prevent a low level of oxygen in the body.
- Bronchodilators may be given to help open up the lungs for better oxygenation.
- Steroids may be given to lessen inflammation and help the lungs heal.
- If you smoke, stop. Avoid places where people are smoking.
When to contact your care team
Call your care team if you are having signs of pneumonitis. Call 911 if you suddenly become short of breath.
Abeloff M, Niederhuber JE, Armitage JO, Doroshow, JH, Kastan MB, Tepper, JE. Abeloff’s Clinical Oncology. 5th edition. Philadelphia: Churchill Livingstone; 2014.
Canadian Cancer Society. Radiation pneumonitis. Found at: http://www.cancer.ca/en/cancer-information/diagnosis-and-treatment/managing-side-effects/radiation-pneumonitis/?region=on