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How to minimize radiation from body? How to help lung? How to reduce lung fibrosis? Foot baths in clay help?

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How to minimize radiation-induced pneumonitis/fibrosis effects of Prenison and radiation inflamation to improve healing??? (3 detailed sub-questions at end of the Background)

Background. Age 58, male, 160 lbs (normally 185-90). Had Hodgkins lymphoma 11 years ago, ended up being successfully treated through perfect match). Currenty lung function is roughly 35% (I think) --- enough to get me through most days, unless I get sick and see (and feel) my O2 saturation drop. I've really been hit hard by Prednisone, and I keep trying to workout (bike, weights) but struggle to get muscle rebuilt.

15 months ago I was successfully treated for recurrent Hodkins (had 1st 11 years ago), using 3 months of chemo followed by 3 weeks of targeted radiation at the tumor near my kidney & stomach. In July/0000 (six months after radiation ended in Feb/11), I became short of breath and ultimately ended up in ER After mistakenly pursuing "pneumonia" treatment (antibiotics) with no luck, an open lung biopsy was done which indicated radiion aveolar damage/fibrosis. I was put on 40mg Prednisone for 1st week and then tapered; and 24x7 supplemental oxygen. A month later I was off oxygen support, and have just enough lung function for short disance walking, etc. Prednisone had tapered down to 7.5mg and I was started in mid-Nov/2011 on 500mg x 2 Mycophenolate with the goal of getting off of prednisone sooner. It was chosen for that plus the least impact to my kidneys, which are technically stage3). (Prednisone, for me, caused 15lb+ weight loss, muscle atrophy, and inability to get weight/muscle back until Pred is much lower -- e.g. it shriveled me up and zapped strength). But 2 weeks after Mycophenate started --- I got bronchitis, cellulitis/leg, eyelid bacterial infection, tongue thrush and bad Flu during (all in Dec/11). SOB came back and I was on O2 all Dec/11 with Prednisone set back up to 20mg on a 4-week 2.5mg taper I also had an Upper Endoscope done end-Dec, and they 'stopped' going as XXXXXXX as usual cuz they were running into inflammation (bottom of 'food pipe' I thnk). So that told me that Radiation not only inflamed lungs but also upper stomach - almost 1-foot away from the tumor lower down. (I also have worsened GERD, and was changed last few weeks from 20mg to 40mg x2, which has helped)

I've also taken NAC (acetyl ciestene) 600mg x3, with doctors support (goal is increase glutathione). Plus daily Viagra which I got prescribed for lung artery vasodilation. I can notice improved SOB on the viagra. A week ago, with advent of liposomal GSH (glutathione), I take 500mg daily and have noticed body and some lung improvement

My detail questions on my radiation-induced lungs are:
1) Is there any change or more options I could do to help lung (& digestive) healing, such as nebulized GSH, etc.? (A number of very recent technical articles published in latter/2011 refer to Glutathione, SOD's, etc. to aide in lung recovery.
2) Are you aware of any new or soon to be released treatments to reduce lung fibrosis?
3) Ways to remove radiation from body? (A year past radiation, I get concerned on my Upper Endo when they say its still going on). I've seen radiation-detox approaches outlined, such as Bentonite clay baths, etc. and even some XXXXXXX supplements that claim to remove radiation. Or are these all not really removing Radiation but instead other detox materials from liver, etc. Do footbaths in clay oer detox materials work just as well --- if "at all"?
Posted Sun, 6 May 2012 in Lung and Chest disorders
Answered by Dr. Gyanshankar Mishra 8 hours later
Thanks for posting the query.

After going through your query, I would like to comment the following:

You seem to be a case of successfully treated recurrent Hodgkin's lymphoma with radiation induced lung fibrosis, having been treated with prednisolone, mycophenolate, NAC, Sildenafil and liposomal GSH for the same.

1.     The mainstay of therapy for radiation induced lung fibrosis is oral steroid therapy. Inhaled steroid therapy may reduce the incidence of side effects associated with oral steroid therapy. Liposomal superoxide dismutase (LIPSOD) has been previously shown to successfully treat radiation induced lung fibrosis. However, fibrosis in any form is irreversible most of the times. In very severe end stage lung fibrosis, lung transplant may be the ultimate option. Try to increase the anti oxidants in your diet. That will somewhat decrease the oxidant damage by radiation like take plenty of fresh fruits, garlic, fresh vegetables, etc.

2.      Preliminary studies have shown that combining pentoxifylline and vitamin E promotes regression of clinical radiation-induced fibrosis. Vasodilators like sildenafil, pentoxifylline have an experimental role in treatment of radiation induced lung fibrosis. Inhaled bronchodilators and oxygen therapy will help in symptomatic relief in radiation lung fibrosis.

3.     On the ways to remove radiation from body, there are no medically substantiated ways to remove radiation in the body. With passage of time the radiation levels gradually wean off (Called the half life). No medical literature supports such claims of radiation removal from the body. There are drugs for radio protection but not for "radio elimination". If a person is exposed to a high amount of radiation that is life threatening, then he/she will need to be decontaminated and may need transfusions of fluids, red blood cells, white blood cells, and platelets.
I hope I have answered your query. I will be glad to answer any follow up queries.

Please accept my answer if you have no follow up queries.


Dr. Gyanshankar Mishra
Above answer was peer-reviewed by
Follow-up: How to minimize radiation from body? How to help lung? How to reduce lung fibrosis? Foot baths in clay help? 16 hours later
Would GSH be at least, more, or less effective than Vit E for fibrosis improvement? And with the GSH (and E, OR E?)) taken alongside them. Can you point to a few key web URLs' of recent successful trials or usage of Pentoxifylline & Vit E? I'm using liposomal oral GSH, should I also be using (oral) GSH in nebulizer, etc>? At roughly what dosage/frequency of GSH oral? And if the nebuliized format, is that simply GSH liquid?

And is Viagra + lipGSH (which prior to lipGSH recent availabilityk was NAC (acetyl cisetene) similar enough to Pentoxifyline + E? With premise that lipGSH is a more 'motherlode' and master antioxidant that E.

The goal of Cellcept is to be the maintenance drug, and eliminate or greatly reduce Prednisone after about 1 year (six more months). I understand both Cellcept and Prednisone are to stop autoimmune conditions - e.g. the case of my lung having it attack aveolar again due to remaining radiation inflammation, etc. However, I'm questioning how auto-immune mitigating they are, as my pre-existing feet peripheral neuropathy PAIN has increased a bit with all the recent treatments and XXXXXXX inflammation. HOWEVER, when I was on Chemo a year+ ago for 3 months the PN pain went-away during XXXXXXX periods on the Chemo cycles. Which I had understood, deductively, indicated my PN nerve pain is autoimmune driven. Would not Pred and/or Cellcept reduce my PN pain, or am I confusing this with other things?

Lastly, is there anything more I should/can be doing to try to improve lung function - lipSOD, etc,.??? I am exercising daily (treadmill, weights), eating 5-6 lighter meals, etc.`

Thanks again in advance for your follow-up answers!
Answered by Dr. Gyanshankar Mishra 8 hours later

Thanks for the follow up.

After going through the follow up query, I would like to comment the following:

1. Fibrosis in medical terminology is an irreversible process which has occurred as result of aberrant healing in response to tissue injury.

2. Thus it is difficult to revert back fibrosis once it has occurred.

3. However the progression of fibrosis can be slowed or halted and symptomatic improvement can be achieved by certain medicines.

4. I really appreciate the efforts you have taken to research into the therapy for this condition.

5. The recommended medications for this conditions include steroids, mycophenolate and oxygen therapy.Oxygen concentrators may be used for oxygen therapy. In severe cases home respiratory support NIV(Non invasive ventilation) may be used. Other medications are still experimental and need further studies to prove their merit.

6. I would recommend you to undergo a 2 d echo examination and know the cardiac status and also rule out pulmonary hypertension which might be an additional factor leading to your dyspnea.

7. Long term oxygen therapy will definitely help improve your symptoms. Annual flu vaccination and 5 yearly pnemococcus vaccination will help decrease the chances of secondary infection in your fibrosis.

8. Now coming to the experimental drugs. Theoretically antioxidant drugs will help reduce the oxidant injury caused by radiation.

9. GSH: has experimental role in Radiation induced fibrosis.
Ref: WWW.WWWW.WW cn/Article_en/CJFDTOTAL-LCFK0000.htm

Liposomal superoxide dismutase: experimental role.
10. Vitamin E + Pentoxyphylline:

The treatment of 34 radiation-induced superficial fibrotic lesions with pentoxifylline and vitamin E for 3 months revealed a significant effect of the Pentoxifylline-vitamin E combination in improving radiation-induced fibrosis.
Six months' treatment of combined Pentoxiphylline/Vit E can significantly reduce superficial Radiation induced fibrosis.

A combination of pentoxifylline (TrentalĀ®), a methylxanthine derivative structurally related to theophylline and caffeine, and vitamin E (alpha tocopherol) may be effective in treating radiation-induced fibrosis (Delanian S et al. 1999).

For fibrosis caused by radiation: vitamin E 1000 IU daily in combination with pentoxifylline 800 mg can be used.

11. 800 mg three times/day, orally administered Pirfenidone may be useful in improving lung functions in radiation induced lung fibrosis.
12. Also you may join a pulmonary rehab program if available near your location.

13. Do consult you physician for annual influenza and 6 yearly pneumococcal vaccine to reduce the risk of secondary infection in the fibrosed lung part.

I hope I have answered your query. I will be glad to answer any follow up queries.

Please accept my answer if you have no follow up queries.


Dr. Gyanshankar Mishra
Above answer was peer-reviewed by
Follow-up: How to minimize radiation from body? How to help lung? How to reduce lung fibrosis? Foot baths in clay help? 27 hours later
Your response was very helpful! Your responses are as if we were face-face, and very professional. I have a last few questions ...

1. It looks like studies on Pentoxifyline (PTX)+ Vit/E to regress RIF go back several years (10+ in some cases). Why then did PTX + Vit/E not get beyond 'experimental status'?

2. I understand the 'type' of Vit/E tocopherol used is d-alpha-tocopherol? (Natural (not synthetic)?

3. My regional pulmonary suggested (as experimental) Viagra + NAC 600mg x3 to halt (but not regress it) fibrosis progression and with the viagra as vasodilator to improve blood flow to lungs. Do you have insights and/or awareness of that approach?

4. Is Viagra a viable alternative to Trental in experimentally trying to regress lung fibrosis? (I do see Trental on my Health Insurance approved list, while Viagra is not)

5. For the Lipsomal superoxide dismutase, is an OTC version (pharmaceutical grade) used or is there a prescription version needed?

6. On Perfenidone, I understand its 'approved' in Japan and some Europe countries, and that U.S FDA initially did not approve it recently. Do you have insight into why FDA did not approve Pirfenidone for lung fibrosis reversal, and/or do U.S. patients obtain it via going to a Country doctor where its approved?

7. LAST QUESTION - AND This one is optional since it wasn't directly part of original 'minimize / reduce fibrosis' question.... I have constant painful Peripheral Neuropathy of feet from Hodgkins 12 years ago (had a abone marrow transplant; but vancristine burned my foot nerves). I understood that the PN pain was triggered by Autoimmune conditions. When Hodgkins recurred 1.5 years ago, during Chemo XXXXXXX periods, my PN pain 'WENT AWAY'. Now, with my Lung damage state, the PN is worse. I understood that the main reason I'm on Prednisone and Mycophenolate (now, and long term after Pred done) is to mitigate Autoimmune re-flareup of radiation induced fibrosis of my lungs. My question: "If Mycophenolate mitigates autoimmune state, is there any obvious reason why it has not helped my foot PN?
Answered by Dr. Gyanshankar Mishra 19 hours later

Thanks for posting the follow up query.

After going through the follow up query, I would like to make the following comments. I have also provided suitable links so that you can get a clearer picture of the entire situation.

1. The combination of pentoxyphylline + vitamin e , though having proved to have been effective in reducing the fibrotic areas are still in the list of experimental drugs because you need trials with a large sample size preferably in a multicentric setup to give validated results. Trials on a larger scale are required before any drug can be used for patients. So the trials still need to be done. However, recent evidence suggests that "Despite a lack of large, well-designed clinical trials, pentoxifylline plus vitamin E should be considered as an option in patients with symptomatic RIF." [ Ref:]

2. The vitamin E used in the trials was d alpha tocopherol , which is commercially available as Vitamin E capsules in market.

3. Sildenafil (viagra) is a vasodilator and should act in the same way as pentoxyphylline (by increasing the blood flow). I am not aware of any trials of sildenafil in radiation induced fibrosis but its results are not encouraging in idiopathic pulmonary fibrosis. [ Ref: WWW.WWWW.WW 1056/NEJMoa0000]
As per the American academy of Family Physicians guidelines (2010), only steroids and pentoxyphylline are recommended for management of radiation pneumonitis. [ Ref: WWW.WWWW.WW
4. I would recommend pentoxyphylline (in Trental) in comparison to viagra for management of your condition.

5. Copper/zinc (Cu/Zn) SOD (super oxide dismutase was used in the trial. Remember the pills should be enteric coated. Please get it prescribed from your physician. Do not self medicate.

6. Regarding pirfenidone , I would like to mention here that, we prescribe it to our patients of idiopathic pulmonary fibrosis. The only worry is photosensitive reaction, so you also need to prescribe a sun screen cream with it!
As far as the US FDA approval is concerned, it has not been approved in idiopathic pulmonary fibrosis due to lack of well controlled clinical trials.

7. The relation between mycophenolate and peripheral neuropathy:
You seem to have suffered previously from vincristine induced peripheral neuropathy. However, peripheral neuropathy does not respond very well to mycophenolate and is sometimes associated with its use.
[Ref: WWW.WWWW.WW x/full]
I hope I have answered your query. I will be glad to answer any follow up queries.
Please accept my answer if you have no follow up queries.


Dr. Gyanshankar Mishra
Above answer was peer-reviewed by
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