Risk for Pulmonary (Lung) Problems Related to Cancer Therapy

Author: Dava Szalda, MD MSHP
Last Reviewed: February 06, 2023

What is the risk?

Some chemotherapies, radiation treatments, and surgeries can cause long term lung issues or problems. In addition, there are some complications of therapy (like graft vs host disease after bone marrow transplant) that may involve the lungs. Many symptoms may develop shortly after therapy, while others may develop months to years later. Lung problems may include obstructive or restrictive lung diseases (a change in the function of the lungs) or lung fibrosis (change in the tissue of the lungs). The risk of developing one of these problems is tied to the total dose of medication a person has received, which treatments or combination of treatments someone received, and any underlying lung issues.

Symptoms/When to Call

Pulmonary toxicities can cause symptoms such as shortness of breath or chronic cough. Annual history and physicals by a healthcare provider should include a pulmonary exam and review of possible symptoms. If you are experiencing new symptoms of pulmonary toxicities you should contact your care provider.

Prevention and Treatment

Survivors should be aware of their baseline exercise status and let their care team know about any changes. Survivors should also avoid smoking and have an annual lung exam. Depending on the exact treatments received some survivors should have pulmonary function testing (PFTs) after they finish treatment, in follow up, or with change of symptoms. Additional tests would be ordered if needed depending on symptoms so it’s important to let providers know about new symptoms and ensure all providers are aware of all therapy received.

Children's Oncology Group. Lung (Pulmonary) Health.

Liles, A. et al. Monitoring pulmonary complications in long-term childhood cancer survivors: Guidelines for the primary care physician. Cleveland Journal of

Medicine. Vol 75, Num 7. July, 2008.

Schindera, C. et al. Pulmonary Dysfunction after Treatment for Childhood Cancer. Comparing Multiple-Breath Washout with Spirometry. 2020. Annals of the American Thoracic Society.

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