Lung toxcity from Bleomycin and recently "degloved" lung?!
Question: Lung toxcity from Bleomycin and recently "degloved" lung!?
I was just curious if the lung is more suseptable to lung toxcity from Bleomycin after a lung has been degloved!. I've had 2 pneumothoraxes and during the 2nd one, the surgeon degloved my lung to make it adhere better so it would stay inflated!. My oncologist had stated that my lung is more fragile now and to report any shortness of breath!. It is a known fact that Bleo causes lung toxicity and my onc knows this!.!.!.but does it cause a bigger threat to my "fragile" lung!?
I am starting to get more short of breath and it does seem like it's gotten worse since my last treatment!. Would it be ok to go my last four treatments without it!? I am officially in remission, so it should be ok, in my opinion!. But of course, I didn't go to med school to have a professional opinion!.
Oh, and don't tell me to go to the doctor, I already plan on visiting the onc in the morning!.Www@Answer-Health@Com
I am starting to get more short of breath and it does seem like it's gotten worse since my last treatment!. Would it be ok to go my last four treatments without it!? I am officially in remission, so it should be ok, in my opinion!. But of course, I didn't go to med school to have a professional opinion!.
Oh, and don't tell me to go to the doctor, I already plan on visiting the onc in the morning!.Www@Answer-Health@Com
Answers:
Wow, Jenn - you have been through so much already!.
The mechanism of Bleomycin pulmonary toxicity is different!.
It should not compound the problems with the pleural surfaces!.
This surgical procedure should not make you more susceptible to the pulmonary problems of Bleo!. Of course pleural problems on top of any Bleo pulmonary toxicity may tend to compound the problems / symptoms with lung function!.
When you see your doc you may have a simple fingertip oximetry done to see if you are getting enough oxygen in your blood!. Your oncologist may consider omitting the Bleo from the last cycles considering your overall situation in CR (complete remission)!. Here's an article that may help!.
http://jco!.ascopubs!.org/cgi/content/abst!.!.!.
Are you under age 40!? There seems to be a greater risk of Bleomycin related pulmonary toxicity (BPT) over that age!.
From another article:
"Pulmonary toxicity is predominantly fibrotic and would appear to be immune mediated!. Bleomycin may induce reactive oxygen radicals by forming a complex with Fe3+ (that's ferric iron)!.
A number of risk factors for developing BPT have emerged from various clinical trials!. However, few reports have had sufficient statistical power to detect significant trends!. Most studies describe case reports or retrospective studies with small numbers of events!. Risk factors described include cumulative dose, low GFR (that's kidney function), older age, supplemental oxygen exposure, bolus drug delivery (as opposed to continuous infusion), extent of lung metastases and prior lung disease!. Of these, cumulative dose and reduced renal function are the most well established risk factors!. At doses between 100 000 and 450 000 IU toxicity is sporadic, while at doses above this range the incidence rises steeply!.
Cigarette smoking has been suggested as a risk factor for BPT ; however, patient numbers are small!. Other suggested factors include dose rate, combination with other drugs, and the use of growth factors!."
Added Note - Interstitial infiltrates on the repeat chest X-ray would suggest pulmonary toxicity from the bleomycin!.Www@Answer-Health@Com
The mechanism of Bleomycin pulmonary toxicity is different!.
It should not compound the problems with the pleural surfaces!.
This surgical procedure should not make you more susceptible to the pulmonary problems of Bleo!. Of course pleural problems on top of any Bleo pulmonary toxicity may tend to compound the problems / symptoms with lung function!.
When you see your doc you may have a simple fingertip oximetry done to see if you are getting enough oxygen in your blood!. Your oncologist may consider omitting the Bleo from the last cycles considering your overall situation in CR (complete remission)!. Here's an article that may help!.
http://jco!.ascopubs!.org/cgi/content/abst!.!.!.
Are you under age 40!? There seems to be a greater risk of Bleomycin related pulmonary toxicity (BPT) over that age!.
From another article:
"Pulmonary toxicity is predominantly fibrotic and would appear to be immune mediated!. Bleomycin may induce reactive oxygen radicals by forming a complex with Fe3+ (that's ferric iron)!.
A number of risk factors for developing BPT have emerged from various clinical trials!. However, few reports have had sufficient statistical power to detect significant trends!. Most studies describe case reports or retrospective studies with small numbers of events!. Risk factors described include cumulative dose, low GFR (that's kidney function), older age, supplemental oxygen exposure, bolus drug delivery (as opposed to continuous infusion), extent of lung metastases and prior lung disease!. Of these, cumulative dose and reduced renal function are the most well established risk factors!. At doses between 100 000 and 450 000 IU toxicity is sporadic, while at doses above this range the incidence rises steeply!.
Cigarette smoking has been suggested as a risk factor for BPT ; however, patient numbers are small!. Other suggested factors include dose rate, combination with other drugs, and the use of growth factors!."
Added Note - Interstitial infiltrates on the repeat chest X-ray would suggest pulmonary toxicity from the bleomycin!.Www@Answer-Health@Com