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What Is Pneumonitis and Why Can It Occur During Mesothelioma Treatment?

Published on Sep 16, 2021 at 2:49 pm in Mesothelioma Information.

Doctor looking at lung xrays

Pneumonitis is a serious problem that can occur during radiation or immunotherapy treatments for various types of cancer. It can be notably problematic when treating cancers that involve the lungs. Mesothelioma patients, particularly those who have been diagnosed with pleural mesothelioma affecting the lining of the lungs, need to be aware of this condition and why it can occur during mesothelioma treatment. Let’s take a closer look at what pneumonitis involves and how it is caused and treated. Remember to speak with your doctor if you have any questions or concerns that you may be at risk for developing this condition.

What Is Pneumonitis?

Pneumonitis is a medical term referring to inflammation of the lungs. In contrast with pneumonia, which is an infection, pneumonitis is lung inflammation without infection. Because pneumonitis can be a side effect of cancer-treating therapies, mesothelioma patients are exceptionally susceptible to this condition. Symptoms typically appear after a radiation or immunotherapy course is completed, not while it is ongoing. In cases in which a patient develops pneumonitis as a consequence of cancer treatment, it is most common to find that pneumonitis appears two to three weeks after the completion of the therapy.

Those diagnosed with and receiving treatment for mesothelioma should be on the lookout for symptoms of pneumonitis. Symptoms should be communicated with a treating physician as soon as they appear to avert any future complications. These symptoms will primarily consist of:

  • Dry cough (without mucus, or with minimal clear mucus)
  • Difficulty breathing or shortness of breath
  • Lowered oxygen levels, either at rest or during physical exertion
  • Fatigue

Why Does Pneumonitis Occur During Mesothelioma Treatment?

One of the primary ways a mesothelioma patient can get pneumonitis is through radiation therapy. Radiation can be directly beneficial in treating the disease as well as helpful in consolidating the benefits of other forms of treatment like surgery. Patients undergoing radiation therapy should know that it is widely known to cause inflammation in the lungs, whether it is used to treat mesothelioma or another illness. Furthermore, the effects of this treatment are not necessarily limited to the area in which the radiation is administered. For example, radiation may be targeted to one area of the left lung, yet pneumonitis can manifest in the right lung. Pneumonitis which results from radiation therapy is commonly referred to as “radiation pneumonitis.”

Immunotherapy, either in combination with chemotherapy or on its own, can also lead to the development of lung inflammation. “Immunotherapy pneumonitis” often occurs when the immunotherapy treatments stimulate immune responses against a variety of tissues in the body, not only the targeted tumors, and healthy, normal cells are attacked as a result. This has been seen many times in the treatment of lung cancers, as air passages and small air sacs are affected simultaneously with the immune response against the cancer. The emergence of immunotherapy as a valid treatment option for mesothelioma is a tremendous advancement in the fight against this cancer, but doctors still need to take precautions against immune-related adverse effects. Pneumonitis is one of the side effects doctors and patients should look out for when treating mesothelioma.

How Is Pneumonitis Diagnosed?

It is important to keep your doctor informed of any changing or worsening symptoms, such as the ones listed above, as you are working through your mesothelioma treatment. Catching symptoms early can help your doctor identify and treat any problems as they arise. When you are a mesothelioma patient, it is likely that you already have decreased lung functioning going into therapy treatments, and are especially vulnerable to the effects of pneumonitis.

A doctor examining a patient for pneumonitis may find a white, cloud-like image on X-ray slides where a normal lung would show only empty black space, a strong indicator that the condition may be present. As cloudiness on medical imaging is not a common presentation of mesothelioma, it is usually a straightforward procedure for a treating physician to differentiate between the progression of the cancer and the development of pneumonitis. Only in rare cases will mesothelioma present as cloudiness on an X-ray. However, in addition to examining X-rays or CT scans, a doctor needs to have a thorough knowledge of a patient’s clinical history in order to determine whether the condition is pneumonia or pneumonitis, as the two can be difficult to distinguish without knowledge of the cause of inflammation.

Can Pneumonitis Be Treated?

This illness can be treated with the required care, attention, and medical resources. Dealing with pneumonitis often requires a multidisciplinary approach, as there are many implications of treating pneumonitis in a patient who has already been diagnosed with mesothelioma. A team of doctors including the radiation oncologist (the physician overseeing radiation treatments) and pulmonologist (a respiratory system specialist) can make decisions regarding treatment and ways to counteract the potentially-harmful side effects of those treatments. Although pneumonitis is curable with the appropriate drug therapy, there is often a permanent scarring of the lung which can have long-term effects decreasing lung functioning.

Treating pneumonitis normally involves the use of high-dose steroids administered for extended periods of time. An orally-administered corticosteroid called prednisone is commonly used. Dosage will be determined based on the patient’s body weight. When drugs are given at too low a dosage or for too limited a time period, the patient is at risk of suffering a recurrence of pneumonitis. However, there are significant side effects the doctor will need to consider. Insomnia or an allergic reaction are among them, but the greatest danger associated with this course of action for mesothelioma patients lies in the use of a drug which is an immunosuppressant.

Speak with a Mesothelioma Lawyer Who Knows Mesothelioma

For those who have had to face mesothelioma in their lives, either as a diagnosed patient or as the loved one of someone with mesothelioma, every day can bring new and unexpected challenges. While you are focusing on emotional health, comfort, and overall wellbeing, the legal matters of your case should be in the hands of a capable legal professional.

A mesothelioma lawyer who understands the disease and the impact it has on the lives of those involved can be a great ally in a very difficult period. We invite you to reach out to our office with any questions. We can schedule a free, no-obligation consultation to discuss the details of your case.

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