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Can pneumonitis be diagnosed with a chest exray?
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Can pneumonitis be diagnosed with a chest exray?

› Forums › General Melanoma Community › Can pneumonitis be diagnosed with a chest exray?

  • Post
    • December 28, 2017 at 2:01 am
    sister of patient
    Participant

      Hey folks,

      Quick question I hope – my sister is showing signs of pneumonitis and we managed to get into clinic today – her regular onc is off but substitute onc ordered a chest exray only and said it looked fine. Everything I've read on here suggests it's a CT scan used for imaging.

      She saw her gp last week for what they believed was just really bad bronchitis and she prescribed two different puffers – the reg. blue one and the orange "rescue" one but there have been several times in the past week where even using both together, at max. dose, she still couldn't get her breath back (it's really alarming to see her like this – sounds like she's being strangled).

      The other reason I suspected pneumonitis is because uveitus came on at the same time – extremely blurred vision, black floaters in both eyes and a yellow dot as well in one (she sees them).

      The only thing this sub onc did was to tell her to cancel her next nivo infusion and to keep her next app't. with her oncologist (duh!!! – like she would skip it – really!!).

      So … for those that have experienced pneumonitis, I'm wondering how comfortable you might be with that advice … tho I'm glad the next treatment will be skipped and she'll see her reg. onc. before any further infusions.

      Thanks for any light you can shed!!!

      Barb

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    • Replies
        • December 28, 2017 at 3:32 pm
        Lucas
        Participant

          My pneumonia did not show on x-ray, but was very clear on CT.

            • December 29, 2017 at 3:59 am
            sister of patient
            Participant

              Yeah, that's what bugs me – there's so many things that don't show on an exray that really are there. Thank you Lucas!!

              Barb

            • December 28, 2017 at 5:22 pm
            jennunicorn
            Participant

              With her breathing not improving I would have her ask for CT. When I was having some breathing issues and my onc wanted to check for pneumonitis she just ordered chest CT. It's going to be more detailed than x-ray and could very well show something the x-ray does not.

              Hope she can get this sorted out, I know how uncomfortable breathing issues are. Sending my love to you both and wishing you both a very happy new year 🙂 

                • December 29, 2017 at 4:08 am
                sister of patient
                Participant

                  Hi Jenn – I really hope so too!! With her onc away, she won't see her again until Jan. 16 so won't have a chance to ask 'til then. And, she's still so worried about missing a treatment or stopping treatment that (I worry) she might try to downplay it, if she's feeling significantly better so that her infusions won't stop. Nivo has become kind of a security blanket to her at this point.

                  But thanks for confirming my thoughts!! And you know we both send our love and Happy New Year wishes back to you (I'm going to be watching for your scan report!!!). You take care!! Best, always!

                  Barb

                • December 29, 2017 at 2:56 pm
                Bubbles
                Participant

                  As you suspect, Barb, and the others have mentioned….I too, contend that a high resolution CT of the chest would provide a much better picture of what is going on in your sister's chest than an x-ray would…no matter the findings.

                  Here is a link to a post that has a treatment algorithm for pulmonary side effects (the charts are a little hard to read but there is a link included to the original):  http://chaoticallypreciselifeloveandmelanoma.blogspot.com/2016/07/excellent-pdf-on-how-to-deal-with.html  

                  If it is pneumonitis…which I had a couple of bouts with…simple inhalations of albuterol and an inhaled steroid like budesonide can provide a lot of respiratory relief…so perhaps that is something your sister can ask her onc about at her visit.

                  I wish you both my best.  Celeste

                    • December 30, 2017 at 4:15 pm
                    sister of patient
                    Participant

                      Thank you so much Celeste – the chart was very helpful, as was the inhaler information!! And as the chart shows, the first step at all levels is to delay or miss a treatment, so at least we are doing that. She's getting a bit better every day the further she gets from last infusion, so I am still suspicious that it is pneumonitis.

                      I'm kind of ticked at her optometrist too, though she sees the opthamologist in a couple of weeks. As she had new glasses come in, she asked the optomometrist if he could check for uveitus – – this was a few days ago and the black floaters had mostly gone by then but the yellow dot with a black circle around it is still there – this guy said the retina looked OK (which is good news and we're glad of it) but that the dot and circle might just be a part of aging. Not buying that one!!! 🙂

                      Thank you again and Happy New Year Celeste!!

                      Barb

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