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Four months into keytruda/ lung problems

Forums General Melanoma Community Four months into keytruda/ lung problems

  • This topic has 29 replies, 6 voices, and was last updated 8 years ago by AB.
  • Post
    Sfern5
    Participant

       Does anybody have any information about difficulty with a cough/coughing up blood And  endless " bronchitis" while on Keytruda?

       They postponed a couple of my treatments to put me through pulmonary exams and cardio exams and came to the conclusion I have bronchitis not pneumonitis which would be a side effect of the immunotherapy.    But it won't go away. It's been about 2 1/2 months of and was coughing and pain in my lungs. My tumors are gone but I'm exhausted. We've tried all kinds of  decongestants, steroids and whatnot. Nothing's working. Any insight would be appreciated. Thanks.

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        Bubbles
        Participant

          I don't really know that this will be helpful as it sounds like you have had a lot of testing and treatments…but: Pneumonitis is a well known side effect from anti-PD1 and is treated with a break and steroids….which it sounds like you have already done. Have you been treated with albuterol nebulized breathing treatments (or at least an inhaler) and inhaled steroids like pulmicort or flovent? I ask because asthma is adults if often misdiagnosed as bronchitis. Additionally…it doesn't sound as though you were a kid with asthma (as I was) but I have a personal belief (substantiated somewhat by all my reading) that immunotherapy can exacerbate underlying problems that didn't trouble us much or at all before the immunotherapy (I'm thinking of arthralgias and arthritis, etc.). I had significant problems with asthma flares (and mild pneumonitis once) while on Opdivo. Now that I've been off for several years….my known asthma…is back to its usual self. So…if you haven't already….giving albuterol and an inhaled steroid a try may give you some relief…and wouldn't hurt! However, you may have already been there done that! I wish you well. Celeste

          Bubbles
          Participant

            I don't really know that this will be helpful as it sounds like you have had a lot of testing and treatments…but: Pneumonitis is a well known side effect from anti-PD1 and is treated with a break and steroids….which it sounds like you have already done. Have you been treated with albuterol nebulized breathing treatments (or at least an inhaler) and inhaled steroids like pulmicort or flovent? I ask because asthma is adults if often misdiagnosed as bronchitis. Additionally…it doesn't sound as though you were a kid with asthma (as I was) but I have a personal belief (substantiated somewhat by all my reading) that immunotherapy can exacerbate underlying problems that didn't trouble us much or at all before the immunotherapy (I'm thinking of arthralgias and arthritis, etc.). I had significant problems with asthma flares (and mild pneumonitis once) while on Opdivo. Now that I've been off for several years….my known asthma…is back to its usual self. So…if you haven't already….giving albuterol and an inhaled steroid a try may give you some relief…and wouldn't hurt! However, you may have already been there done that! I wish you well. Celeste

              mhees1964
              Participant

                FYI – I recently saw a melanoma specialist (cutaneous oncologist) at the Moffitt Center in Tampa. He told me that I should avoid steroids as much as possible as it stunts ones auto immune response when you have melanoma. (I had been on a short dose of steroids for a chronic cough).

                mhees1964
                Participant

                  FYI – I recently saw a melanoma specialist (cutaneous oncologist) at the Moffitt Center in Tampa. He told me that I should avoid steroids as much as possible as it stunts ones auto immune response when you have melanoma. (I had been on a short dose of steroids for a chronic cough).

                  cheris
                  Participant

                    It's such a relief to hear that I am not the only patient with bronchitis/cough.  I will be having my 16th Keytruda infusion, and I have become more unwell as time has gone on.  I've had my second bout of bronchitis.  Both times they gave me antibiotics, but like you, it lasted about 3 months.  My thyroid is now so low and my blood pressure is high, along with my blood sugar.  I was also given an inhaler, which helps at times.  Last time my oncologist mentioned taking a vacation, and I automatically said no, but now am rethinking.

                    Cheris

                    cheris
                    Participant

                      It's such a relief to hear that I am not the only patient with bronchitis/cough.  I will be having my 16th Keytruda infusion, and I have become more unwell as time has gone on.  I've had my second bout of bronchitis.  Both times they gave me antibiotics, but like you, it lasted about 3 months.  My thyroid is now so low and my blood pressure is high, along with my blood sugar.  I was also given an inhaler, which helps at times.  Last time my oncologist mentioned taking a vacation, and I automatically said no, but now am rethinking.

                      Cheris

                      cheris
                      Participant

                        It's such a relief to hear that I am not the only patient with bronchitis/cough.  I will be having my 16th Keytruda infusion, and I have become more unwell as time has gone on.  I've had my second bout of bronchitis.  Both times they gave me antibiotics, but like you, it lasted about 3 months.  My thyroid is now so low and my blood pressure is high, along with my blood sugar.  I was also given an inhaler, which helps at times.  Last time my oncologist mentioned taking a vacation, and I automatically said no, but now am rethinking.

                        Cheris

                        mhees1964
                        Participant

                          FYI – I recently saw a melanoma specialist (cutaneous oncologist) at the Moffitt Center in Tampa. He told me that I should avoid steroids as much as possible as it stunts ones auto immune response when you have melanoma. (I had been on a short dose of steroids for a chronic cough).

                          Sfern5
                          Participant

                             Thank you for your reply! I totally agree with everything you say. And I've asked my doctors, several of them,  about an inhaler but they just keep handing me more prednisone. Not a fan of  Prednisone!   That, and they keep redoing the same tests. The pulmonologist did mention potential asthma but I had never had it before. Of course that doesn't preclude being a possible underlying condition, as you said. So frustrated. But thank you for confirming what I was thinking.

                            Sfern5
                            Participant

                               Thank you for your reply! I totally agree with everything you say. And I've asked my doctors, several of them,  about an inhaler but they just keep handing me more prednisone. Not a fan of  Prednisone!   That, and they keep redoing the same tests. The pulmonologist did mention potential asthma but I had never had it before. Of course that doesn't preclude being a possible underlying condition, as you said. So frustrated. But thank you for confirming what I was thinking.

                              Sfern5
                              Participant

                                 Thank you for your reply! I totally agree with everything you say. And I've asked my doctors, several of them,  about an inhaler but they just keep handing me more prednisone. Not a fan of  Prednisone!   That, and they keep redoing the same tests. The pulmonologist did mention potential asthma but I had never had it before. Of course that doesn't preclude being a possible underlying condition, as you said. So frustrated. But thank you for confirming what I was thinking.

                              Bubbles
                              Participant

                                I don't really know that this will be helpful as it sounds like you have had a lot of testing and treatments…but: Pneumonitis is a well known side effect from anti-PD1 and is treated with a break and steroids….which it sounds like you have already done. Have you been treated with albuterol nebulized breathing treatments (or at least an inhaler) and inhaled steroids like pulmicort or flovent? I ask because asthma is adults if often misdiagnosed as bronchitis. Additionally…it doesn't sound as though you were a kid with asthma (as I was) but I have a personal belief (substantiated somewhat by all my reading) that immunotherapy can exacerbate underlying problems that didn't trouble us much or at all before the immunotherapy (I'm thinking of arthralgias and arthritis, etc.). I had significant problems with asthma flares (and mild pneumonitis once) while on Opdivo. Now that I've been off for several years….my known asthma…is back to its usual self. So…if you haven't already….giving albuterol and an inhaled steroid a try may give you some relief…and wouldn't hurt! However, you may have already been there done that! I wish you well. Celeste

                                Bubbles
                                Participant

                                  Just a bit more info:  While at first avoided due to the thought that steriods would impede a response by immunotherapy upon melanoma….we have long learned differently.  Here is a webinar on how to treat side effects by two world renowned melanoma experts:  http://chaoticallypreciselifeloveandmelanoma.blogspot.com/2015/09/side-effects-and-how-to-manage-them-in.html

                                  While one would NOT choose steroids unless absolutely needed…we have learned that for life threatening and debilitating problems like pneumonitis, colitis, and arthritis….steroids can save the patient's life, contain symptoms and allow them to continue needed immunotherapy once the flare has been controlled!!!!  Additionally, INHALED steroids are pretty nifty as they work only in the lungs where they are needed without significant risk of systemic effects.

                                  For what it's worth.  c

                                  Bubbles
                                  Participant

                                    Just a bit more info:  While at first avoided due to the thought that steriods would impede a response by immunotherapy upon melanoma….we have long learned differently.  Here is a webinar on how to treat side effects by two world renowned melanoma experts:  http://chaoticallypreciselifeloveandmelanoma.blogspot.com/2015/09/side-effects-and-how-to-manage-them-in.html

                                    While one would NOT choose steroids unless absolutely needed…we have learned that for life threatening and debilitating problems like pneumonitis, colitis, and arthritis….steroids can save the patient's life, contain symptoms and allow them to continue needed immunotherapy once the flare has been controlled!!!!  Additionally, INHALED steroids are pretty nifty as they work only in the lungs where they are needed without significant risk of systemic effects.

                                    For what it's worth.  c

                                      pookerpb
                                      Participant

                                        My husband developed mild case of pnuemonitis after 5 mos of Keytruda last year. Cough, shortness of breath that wouldnt go away. He was a ridiculous high dose of prednisone for 6 weeks and his pneumonitis was mild. The damange to  your lungs this type of thing can cuase certainly outweighs not being on prednisone if that ends up being what it is. FYI….his tumors grew while on streroid but the lung issue was nothing to mess with for sure. It went away after teh 6 weeks and treatmetn started up again. I think he was on 120mg 2x day for a while before tapering down.

                                         

                                        pookerpb
                                        Participant

                                          My husband developed mild case of pnuemonitis after 5 mos of Keytruda last year. Cough, shortness of breath that wouldnt go away. He was a ridiculous high dose of prednisone for 6 weeks and his pneumonitis was mild. The damange to  your lungs this type of thing can cuase certainly outweighs not being on prednisone if that ends up being what it is. FYI….his tumors grew while on streroid but the lung issue was nothing to mess with for sure. It went away after teh 6 weeks and treatmetn started up again. I think he was on 120mg 2x day for a while before tapering down.

                                           

                                          Sfern5
                                          Participant

                                             That's interesting. I'm sorry for his difficulties, but thank you for sharing that with me. It's always good to know if other people are having the same troubles. Makes me feel a little less alone. I Hope he is doing well now. Thanks again.

                                            Sfern5
                                            Participant

                                               That's interesting. I'm sorry for his difficulties, but thank you for sharing that with me. It's always good to know if other people are having the same troubles. Makes me feel a little less alone. I Hope he is doing well now. Thanks again.

                                              Sfern5
                                              Participant

                                                 That's interesting. I'm sorry for his difficulties, but thank you for sharing that with me. It's always good to know if other people are having the same troubles. Makes me feel a little less alone. I Hope he is doing well now. Thanks again.

                                                pookerpb
                                                Participant

                                                  My husband developed mild case of pnuemonitis after 5 mos of Keytruda last year. Cough, shortness of breath that wouldnt go away. He was a ridiculous high dose of prednisone for 6 weeks and his pneumonitis was mild. The damange to  your lungs this type of thing can cuase certainly outweighs not being on prednisone if that ends up being what it is. FYI….his tumors grew while on streroid but the lung issue was nothing to mess with for sure. It went away after teh 6 weeks and treatmetn started up again. I think he was on 120mg 2x day for a while before tapering down.

                                                   

                                                  Sfern5
                                                  Participant

                                                     Thanks again! Excellent information! I'm going to try and get the inhaler instead of the oral steroids. They're very tough on me. But you're right, it's better then the other choices. You've been very helpful! Ty

                                                    Sfern5
                                                    Participant

                                                       Thanks again! Excellent information! I'm going to try and get the inhaler instead of the oral steroids. They're very tough on me. But you're right, it's better then the other choices. You've been very helpful! Ty

                                                      Sfern5
                                                      Participant

                                                         Thanks again! Excellent information! I'm going to try and get the inhaler instead of the oral steroids. They're very tough on me. But you're right, it's better then the other choices. You've been very helpful! Ty

                                                        Sfern5
                                                        Participant

                                                           

                                                           Sfern5 –  (4/8/2016 – 3:43pm)

                                                           Thanks again! Excellent information! I'm going to try and get the inhaler instead of the oral steroids. They're very tough on me. But you're right, it's better then the other choices. You've been very helpful! Ty

                                                          Cancer, Schmancer.

                                                          Sfern5
                                                          Participant

                                                             

                                                             Sfern5 –  (4/8/2016 – 3:43pm)

                                                             Thanks again! Excellent information! I'm going to try and get the inhaler instead of the oral steroids. They're very tough on me. But you're right, it's better then the other choices. You've been very helpful! Ty

                                                            Cancer, Schmancer.

                                                            Sfern5
                                                            Participant

                                                               

                                                               Sfern5 –  (4/8/2016 – 3:43pm)

                                                               Thanks again! Excellent information! I'm going to try and get the inhaler instead of the oral steroids. They're very tough on me. But you're right, it's better then the other choices. You've been very helpful! Ty

                                                              Cancer, Schmancer.

                                                            Bubbles
                                                            Participant

                                                              Just a bit more info:  While at first avoided due to the thought that steriods would impede a response by immunotherapy upon melanoma….we have long learned differently.  Here is a webinar on how to treat side effects by two world renowned melanoma experts:  http://chaoticallypreciselifeloveandmelanoma.blogspot.com/2015/09/side-effects-and-how-to-manage-them-in.html

                                                              While one would NOT choose steroids unless absolutely needed…we have learned that for life threatening and debilitating problems like pneumonitis, colitis, and arthritis….steroids can save the patient's life, contain symptoms and allow them to continue needed immunotherapy once the flare has been controlled!!!!  Additionally, INHALED steroids are pretty nifty as they work only in the lungs where they are needed without significant risk of systemic effects.

                                                              For what it's worth.  c

                                                              AB
                                                              Participant

                                                                Help! I am having the same problem. I can't get better, and would rather be dead than live like this the rest of my life. My quality of life is terrible. I want from tri-athlete to try- to get out of bed, and my oncologist just says it's not related. I really need another oncologist too.

                                                                  AB
                                                                  Participant

                                                                    Follow up : NED and felt great from 3/1- now!

                                                                    I knew 2 weeks after my 1st infusion, on 2.3.17, that it was working. The ping pong sized lymph nodes on both sides of my hip/upper inside of leg had shrunk.

                                                                    keytruda side effects have been minimal- can only do 2 hours of cardio band yoga daily- that's 1 less hour- I'm not as fast, a little achy at times and a little itchy.

                                                                    3 infusions later- I'm NED. I had 5 tumors in my right leg the size between a plum and a tennis ball and they, as well as the lymph node cancer is all gone.

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