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Dr. Andrew Rynne

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Taking treatment for pneumonia and asthma. X-ray showed shadow on lungs. Could it be cancer?

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Dr. Gyanshankar Mishra

Pulmonologist

Practicing since :2003

Answered : 600 Questions

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Posted on Mon, 11 Feb 2013 in Lung and Chest disorders
Question: hello my name XXXXXXX i'm 36 yrs old today i'm just getting over pneumonia and the hospital found shadows on both of my lungs via an x XXXXXXX i was put on antibiotics and steroids for my asthma as my breathing hasn't been to clever. i got to have another x XXXXXXX done in 6 weeks time, which iv'e got another 3 more weeks to wait. iv'e been having chest infection after chest infection since august last year and have been on antibiotics since then on and off until XXXXXXX 2nd when they diagnosed me with having pneumonia. when i'm on the antibiotics i start to feel well but no sooner when iv'e finished the course i start feeling ill again, i feel very tired, weak, lethargic and i just don't feel well at all. can the shadows on my lungs indicate that i have cancer ? and why do i still get chest infections ? even now i think iv'e got another one. i'm also a diabetic type 2 and i'm also anemic which iv'e only recently been diagnosed with. i'm also asthmatic so i already no i have a low immune system but is it normal to keep getting chest infections like i do straight after one another ?
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Answered by Dr. Gyanshankar Mishra 7 hours later
Hi,
Thanks for posting the query on XXXXXXX
After going through the query, I would like to comment the following:

1. You seem to have been diagnosed with diabetes and asthma along with secondary respiratory infections.

2. I would suggest you get yourself clinically evaluated by a Pulmonologist.

3. The chances of lung cancer are very remote since your condition responds to antibiotics. Please do not stress yourself regarding this.

4. Being diabetic definitely puts you at risk of secondary infections and hence a proper control of your blood sugar is reuired. Both blood sugra levels(fasting and postmeal) and gkycated HbA1c levels will help us in knowing your blo0od sugar control status.

5. For asthma investigations required are chest xray, pulmonary function tests and serum IgE levels. Depending the evaluation reports, you management can be individualised. Considering your clinical profile, there is a chance of you suffering from ABPA(Allergic broncho pulmonary aspergillosis). Serum IgE levels both total and specific will help to rule out the diagnosis along with a ct scan of thorax.

6. Also yearly flu vaccine and 5 yearly pneumococcal vaccine is reccommende to be take by you to reduce the incidence of secondary respiratory infections.

I hope I have answered your query. I will be glad to answer follow up queries if any.
Please accept my answer if you have no follow up queries.

Regards

Dr. Gyanshankar Mishra
MBBS MD DNB
Consultant Pulmonologist
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Gyanshankar Mishra 3 hours later
If the shadows are still there when i have my second x XXXXXXX what could that mean?
doctor
Answered by Dr. Gyanshankar Mishra 2 hours later
Hi,
Thanks for the follow up query.
After going through the follow up query, I would like to comment the following:

1. If the shadows persist on xray then they need to be evaluated in detail. The serial xrays need to be studied as to how the shadows have evolved i.e if they have regressed, progressed or have remained static. Also the type of shadows needs to be seen.

2. Further evaluation in the form of sputum examinations (gram stain and culture, afb stain and culture), Blood investigations and CT thorax needs to be done. Also investigations advised in the previous posts need to be done.

3. In case an infective etiology is supected then a bronchoscopic examination may be helpful for isolation of the infective cause. Infective etiology could either be bacterial, fungal or tubercular.

4. The management needs to be directed at the specific etiology if infection is suspected.

5. Also all the previous chest xrays in your life time need to be re evaluated to see if theses are "fleeting" shadows.

6. Please visit a Pulmonologist for clinical evaluation in detail as outlined above.

I hope I have answered your query. I will be glad to answer follow up queries if any.
Please accept my answer if you have no follow up queries.

Regards

Dr. Gyanshankar Mishra
MBBS MD DNB
Consultant Pulmonologist
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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