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Cavitary MAC - what makes cavity shrink?
Happy new year everyone,
I have been doing some research on Cavitary MAC - as I see some people's cavities shrink/close fast. I try to figure out what shrink a cavity. Is it based on drug sensitivity test? If you are sensitive to Arikayce, your cavity shrink fast? Or if your lung ventilation/air flow is better, the medicine can get into cavity quickly? Why some people's cavities are stubborn while some others' go away fast?
I checked with a few doctors and they all have different opinions. Some said cavity never goes away, some advise me to try arikayce. Some say that my cavity has a 50% chance to close. NJH says that a cavity less than 2cm has a better chance to close. Some patients have 3cm cavity ( thick walled) still close quickly. Some others have cavity for over 18 months and still there. So what is the deciding factor?
Any input will be appreciated. I wish everyone regain their health in 2025!
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current international treatment guidelines suggest initiating treatment in patients
with cavitary lung disease (rather than watchful waiting)
here a recent paper from Korea about these MAC cavities
https://www.nature.com/articles/s41598-024-71971-6.pdf
50% had "obliteration"
(when they say "mortality rates" they seem to mean survival rates)
they think cavity obliteration , and thus cure, after treatment just depends
on (unpredictable) treatment response
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1 ReactionI agree with you Bsi15, mortality means survival here in this paper.
I saw this article before and it is very promising that 50% of the patients had obliteration after 12- 20 months treatment. Most doctors told me if cavity did not shrink/close within 4-6 months, surgery should be considered. They also don't think cavity can close because there is no blood flow.
However I have seen outliners whose cavities shrink significantly within 4-6 months or collapse within 13 months. I also heard case that cavity closed within 3 years. It is really case by case, and we always hope for the best.
I have permanent scar tissue in and around my cavity. It will never close, nor has it increased in 6 years.
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2 ReactionsThat is very stable Rick and it is good. If it never increases, it is lazy, then you dont need to worry about it.
But it traps other things like aspergillus 🙁 and it can tear loose causing hemoptysis
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3 ReactionsYes Rick. It is chronic and progresses sometimes. That brings us fear, anger and uncertainty in life. It is also hard to stay positive among these emotions. But new medicine and technology are also on the way. There is always a hope. I also encourage myself that it is a battle, a very hard battle and it needs a lot of courage, hope, self-encouragement and team work. If we can't cure it, we slow down its progress, which is also a success. We gain time for us, and that gives an opportunity too.
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2 ReactionsIn CHina, they injected the antibiotics inside the lung cavities to kills bacteria directly. It sounds very aggressive!
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1 ReactionPlease explain tear loose?
I have excruciating pain where my largest cavity is.is that common?
After/during intense exercise, the lung expands rapidly but scar tissue does not expand, so it pulls off the cavity wall and bleeding occurs until it clots
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3 ReactionsI'm currently being treated for cavitary MAC with the big three antibiotics. Even though there was only one positive sputum test, because of a cavitary lesion and the severity of my symptoms, primarily extreme productive coughing, my doctors thought it was a good idea to start treatment right away. The fact that the cavity's walls had thickened since my last CT in 2022 was another factor. My ID doc wants to add arikayce to the regimen, but we are running into insurance problems. Best of luck to all members.