Question Last fall my 62 yr old sister was diagnosed with lung cancer. Quit smoking in 2006 but obviously quit too late. She went through Chemo and Radiation but the surgeon felt she would not survive a surgery due to age and other conditions. In mid July a chest CT showed that her tumor was stable but 2 white patchy areas were seen in the affected lung. They thought this was scar tissue due to Radiation. This month she developed shortness of breath with exertion and had another CT scan. Now there are multiple white patchy areas in both lungs. Oncologist has no clue as to what these are. She's been on two different antibiotics and 10mg prednisone with no improvement. Shes got an appointment tomorrow with a lung specialist (her first appointment) but does anyone have an idea of what these things could be? I don't know of anything that would multiply in one months time. The CT scan actually looks as if someone shook white paint off of their hands and the paint just splattered randomly on/in the lungs.
Answer It sounds as though she has patchy interstitial pneumonitis, which would be consistent with several things including radiation pneumonitis. However, the differential includes several infectuous agents, a common one being Pneumocystis. If I were her doctor, I would be thinking about alveolar lavage and possible transbronchial biopsy, both of which are serious procedures, but at the rate things are progressing things will only get worse. Please keep me posted as to what is happening.
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Answer worth the three day wait and gives me something to discuss with her doctor if all these other tests turn up negative. Thank you Dr Higby.
I can answer almost all questions related to the treatment and natural course of most kinds of cancer, especially cancers of prostate, colon, lung and breast.
I have been a practicing medical oncologist for 36 years, and have been chief of service at a major medical center for 25 years. I've also done research in cancer treatments.
Organizations American Society of Clinical Oncology
Publications New England Journal of Medicine
American Journal of Medicine
Journal of the American Society of Clinical Oncology
Education/Credentials MD, Stanford University
Internal Medicine residency, St. Louis University School of Medicine, St. Louis, MO
Medical Oncology Fellowship, Roswell Park Cancer Institute, Buffalo, NY
Awards and Honors America's Best Physicians, last 14 years