Background: IIIA T1N2M0 NSCL Lung Cancer. 10/2013 URL Removal followed up with chemoradiation; Radiation to Mediastinum and area of lobectomy. Carbo/Taxol concurrent with 35 radiation treatments; Chemo only 3 treatments - allergic reaction to Taxol replaced with 3 treatments of Cisplatin/Etoposide.
4 months post treatment, ER visit and Pulmonary DR visit follow-up for extreme shortness of breath with minimum exertion, uncontrollable coughing and pressure and pain in chest area. Er chest x-ray showed minor pneumonia. Oxygen saturation normal while resting. Resting heart rate around 120 (previously diagnosed as Inappropriate Sinus Tachycardia-taking Cardizem 180 mg - no previous history prior to cancer treatment). Prescribed Levaquin and reducing dosage Prednizone dose pack. Two day follow-up with Pulmunolgist added Spiriva one puff daily and Proair inhaler up to 4 times daily. Two weeks later no relief and additional severe rib pain from coughing. Taking OTC cough med.
Pulmonologist now diagnoses Radiation Pneumonitis and adds cough medicine with codeine and 15 day reducing dosage Prednisone 10 mg.
My question is regarding diagnosis and treatment. Based on my research this illness can be very serious and lead to fibrosis or death. Also that this condition is controversial in that the diagnosis could be other illnesses. Should other diagnostic tests be done? Maybe CT or MRI? What meds are normally prescribed? No where could I find the standard of care. Should I seek treatment from my oncologist? Should i be concerned the cancer has returned. I really didn't have symptoms prior to cancer diagnosis. Found on incidental chest x-ray. Iam confused and don't feel confident in my care. This is important to me. What is the standard of care for radiation pneumonitis from diagnosis to treatment?