How to prevent radiation fibrosis? - 1248973

didi85
Posts:7

Hello,

My father has completed his 15th radiotherapy session.

Is there a way to prevent radition fibrosis/pneumonitis or pleural effusion?

I have come across this paragraph on radiation fibrosis:

The combination of pentoxifylline and vitamin E may promote a significant antifibrotic effect by reversing deep radiation-induced fibrosis. (Lefaix et al, 1999)

Antioxidant Vitamins And Minerals
Vitamin A - 10,000 IU
Beta Carotene - 25mg
Vitamin D - 800 IU
Vitamin E - 1200 IU
Vitamin C - over 1,000mg
Thiamin (B1) - 50mg
Riboflavin (B2) - 200mg
Niacin (Nicotinic acid) - 500mg
Niacin (Nicotinamide) - 1500mg
Pyridoxine (B6) - 200mg
Folic Acid - 1000mcg
Vitamin B12 - 3000mcg
Calcium - 1500mg
Magnesium - 700mg
Chromium - 1000mcg
Iron - 65mg
Selenium - 200mcg
Zinc - 30mg

Note: Super-antioxidant, Lipoic Acid (50-100mg), can resuscitate all the other net-work antioxidants, plus itself. It is called the "antioxidant's antioxidant." It is the most versatile and powerful of all antioxidants. Unlike any other antioxidant, it is both fat and water soluble because of its unique chemical structure, and thus able to work its miracles in both the watery and fatty portions of a cell, wherever it is most needed.

When an antioxidant like vitamin E or C is exhausted and depleted, Lipoic Acid rushes in to restore it to its full antioxidant powers. It is also the only antioxidant that can reinvent itself as an antioxidant after it has expended itself fighting off free radical assaults.

What do you think?

Is radiation fibrosis and pleural effusion inevitable inevitable outcomes of radiotherapy?

I'd be glad if you could give me some insights.

Thank you,

Dilay

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Reply # - October 12, 2012, 10:07 AM

catdander
Posts:

Hi Dilay,

I am very sorry your father is going through all this and hope he doesn't encounter any of these problems. It is absolutely not inevitable that he will have any of these side effects.
But an antioxidant while something that is quite helpful for cells also include being quite helpful for cancer cells so is something you would not want to supplement during treatment.

One thing I have noted that is getting some play by at least one of our doctors is to suggest a spoonful of oil before radiation treatment that may inadvertently burn the esophagus to stave off esophagitis.

I will ask our oncology pharmacist to comment on this. You should hear back with the day.

Janine
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Reply # - October 12, 2012, 11:36 AM

dr walko
Posts: 102

Dilay,

I would definitely have our radiation oncologist weigh in here too. Regarding pentoxifylline, there is data in lung and breast cancer patients receiving radiation therapy. Compared with placebo, pentoxifylline demonstrated improved perfusion rates and reduced lung injury. No significant treatment related toxicity was seen. Steroids (like prednisone) are also used for treatment of lung toxicities.

In terms of vitamin E, the data I was able to find was mostly in breast cancer and prevention of fibrosis of the breast tissue and lymphedema, rather than lung toxicity specifically. Additionally, the data seemed rather mixed. There are several other ongoing trials of therapies (most in animals) of other substances as well.

Since the rates of lung toxicity from radiation depend on the specific fields being radiated, amount of radiation, use in combination with other therapies like chemotherapy and patient related factors, I would discuss the risk of radiation fibrosis and/or pleural effusion specifically with your father's radiation oncologist.

Best wishes,
Dr. Walko

Reply # - October 13, 2012, 07:59 AM

dr loiselle
Posts: 37

Hi Dilay -

No doubt your father's radiation oncologist spent great time and care designing a radiation strategy that would minimize the risk of radiation induced inflammation ("pneumonitis") in months and weeks following treatment and radiation induced scarring ("fibrosis") which can be permanent.

One important thing to keep in mind is that there will always be some degree of inflammation and scarring. It is analogous to any medical/surgical procedure... after a joint replacement there will be inflammation and scarring, the key thing is that it too is minimized through good surgical technique.

The lungs have a lot of capacity, meaning that if there is inflammation and scarring in one part, the remainder of the lungs will go on doing their job and compensate. Your Dad's radiation oncologist probably strives as we do to keep the risk of inflammation significant enough to cause symptoms to as low as about 1 in 10 patients.

If you Dad does develop inflammation in the lung, the treatment is with a physician prescribed steroid medication, typically prednisone.

We typically advise patients to stay off of vitamins A, C, and E during treatment. Radiation works through a free radical mechanism, and these anti-oxidants in high enough doses may impede the beneficial effect of radiation.

Otherwise, I would not endorse any of the vitamins or supplements you listed. Good food provides more than enough.

To finish addressing your question - pleural effusion (fluid around the lung) can occur as a result of cancer spread around the lung, infection, and any other cause of inflammation - but it is not commonly caused by radiation.

I hope that helps. Good luck.

-Dr Loiselle

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