Drug Induced Interstitial Lung Disease

[Mtngrl]

My last scan showed increased FDG uptake in my lower lungs, with improvement everywhere else, including the upper lobes of my lungs. Some cancer drugs and many other kinds of drugs can cause lung disease, including acute respiratory distress (which can be fatal) and other kinds of inflammation.

Getting oxygen and/or radiation can exacerbate the problem. Nonsteroidal antinflammatory drugs (like ibuprofen) and aspirin can also cause problems. Response varies quite a bit from person to person. There may be synergistic effects as well.

I've found several articles on drug induced interstitial lung disease. About 450 drugs are thought to have the potential to damage the lungs. Among the ones that are of interest to us are Trastuzumab (Herceptin), Paclitaxel (Taxol), and a number of other cytotoxins (i.e. cancer-killers.) Trastuzumab Emtansine (Kadcyla) is labeled as being known to cause interstitial lung disease and acute respiratory distress. So is Lapatinib (Tykerb).

It can be difficult to differentiate between metastatic cancer in the lungs and other inflammation. Treatment is to discontinue whatever drug is causing it, and perhaps to use steroids.

Here's an open-source article on the subject, in case you'd like more information. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3415629/

Here's

[Bunty]

Sorry to read this Amy, but thanks for sharing this important information. Is the plan to see if there is change when you discontinue current treatment and ascertain if this has been the cause of the problems in the lower lungs? I hope this all resolves quickly, and sending you prayers.
Marie

[Mtngrl]

Hi Marie,

I'm actually doing very well. I thought the Kadcyla was the main culprit in my situation, and I went off it in February. My symptoms have diminished, so I was surprised that the PET showed the inflammation increasing. We'll re-scan in August and take it from there. I feel like I'm getting better--less coughing and fewer episodes of shortness of breath and light headedness. The lower lungs can take awhile to heal.

The saga continues. . . .

[waterdreamer]

Hi Amy,
I discontinued Kadcyla not due to progression, but because I could see from my scans and from the way I felt that it was damaging my lungs. I have also stopped Herceptin because it causes severe shortness of breath for me, and I feel it too is damaging my lungs. So it was really great to read the article you shared. My PET/CT scan shows increased uptake in two lymph nodes in my lung as well as the lining of the lower right lobe. I have declined further treatment, despite rising CEA levels as it does not feel like her2+ cancer. It would be interesting to see if they are doing any clinical trials on these side effects and treatment for this.

Best wishes
Fern

[michka]

Thank you Amy for sharing this interesting article.

[Mtngrl]

Those of us who can expect to be on some kind of cancer treatment forever constantly face the challenge of balancing cancer control with side effects/quality of life. Although the "chronic condition" of terminal cancer is different in quality and intensity from other chronic health conditions such as high blood pressure, type-2 diabetes, high cholesterol and the like, it is also similar. All drugs have side effects. Some of them can be ameliorated and some can't. Some eventually stabilize and some keep getting worse. Some are tolerable and others pose additional threats to health or even to life, over and above the threat from condition they are intended to treat.

I've been trying to remember to breathe deeply several times a day. When I was coughing every time I took a deep breath, I developed the habit of breathing shallowly all the time. Now I'm trying to "rehab" my lungs.

Some of my inspiration comes from a friend who was diagnosed with emphysema two years ago. He began training for and running marathons. The lung damage that he started with is irreversible, but he is doing a better job of using the healthy lung tissue that he still has. His lung capacity has improved. His disease is still incurable, but the combination of medication and lifestyle is buying him more time and improving his quality of life.

Now that I know that ibuprofen can exacerbate lung disease, I try everything else I can think of to relieve a headache or body ache--caffeine, hydrating, stretching, napping, meditating--before reaching for the pills. I haven't thrown away all my ibuprofen, but I'm using much less of it.

My liver enzymes became elevated while I took Kadcyla. They are still a little high (and my platelets are a little low.) Maybe the residual side effects of Kadcyla are longer-lived than I thought. Hopefully, the intended effect (of controlling my cancer) is also enduring.

[Kathy T]

Amy, I have been off Kadcyla since Dec. and my liver enzymes remain elevated and platelets low. I'm wondering how many are experiencing the same.
Kathy T

[Adriana Mangus]

Hi everyone,

I guess one way or the other we are doom. I have been on herceptin for about 10 years now, I have never before experience breathing problems until now, but its nos because of herceptin, but due to the cancer progressing despite the treatment (s) I have received.

What are we supposed to do. If we don't receive the treatment how are we going to get better. This information is useful, unfortunately for some of us is too late to reverse any damages all these chemo (s) have done to our lungs.

Thank you for posting.

[Adriana Mangus]

Kathy,

When I was on the TDM1 clinical trial my liver enzymes were elevated as well,
it took months before the count came down. You will see the enzymes coming down soon. It takes a long time.

Adriana

[Mtngrl]

Adriana,

I know what you mean about "damned if you do and damned if you don't" (my words, obviously, not yours.) So much of life is simply lived in gray areas.

A friend had severe liver damage from Kadcyla--almost died. It's labeled for liver toxicity.

I talked about my liver enzyme and platelet numbers with both my oncologist and her PA. Although the levels are outside the optimal ranges, they are OK. And both are heading back to better levels.

[Pray]

Keeping you and your family in my prayers�� Gods blessings to all ��