Pulmonary Toxicity

Author: OncoLink Team
Last Reviewed:

What is it?

Pulmonary toxicity is a term for lung damage. This damage may include inflammation (pneumonitis) or scarring (fibrosis). Inflammation reduces the amount of oxygen that your lungs can absorb. Scarring reduces the amount of air you can breathe in.

Pulmonary toxicity may be caused by chemotherapy, radiation therapy to the lungs, environmental or occupational toxins, medications or genetics. Pulmonary toxicity related to cancer treatment may develop during or shortly after treatment or may be a late effect of treatment, occurring months to years after the end of treatment. The lung damage that causes pulmonary toxicity may be temporary or permanent, with late-onset changes having a greater possibility of being permanent.

Pulmonary toxicity problems can impact your ability to complete daily activities. You may have trouble breathing, be short of breath, tire easily, have a chronic cough or have discomfort with breathing when lying on your back.

How is it managed?

Medical management for lung toxicity includes:

  • Corticosteroids: Steroids decrease inflammation.
  • Oxygen Therapy: Oxygen is delivered through a tube and into your nose. Supplemental oxygen will increase the amount of oxygen in your blood.
  • Narcotics: Pain medication can calm the breathing center in your brain decreasing the amount of work it takes to breathe.
  • Pulmonary Rehabilitation: This includes medications, emotional support, exercise regimens, breathing training, and nutritional counseling to promote daily function.

Self-care associated with pulmonary toxicity includes the following:

  • Stop smoking. Avoid places where other people are smoking.
  • Exercise daily. This may be casual walking, swimming, or light gardening.
  • Elevate your head when lying down.

CT scan, X-rays, blood tests, and lung function tests may be performed to assess and monitor your pulmonary health.

When should I contact my care team?

If you have symptoms of lung damage, contact your care provider immediately:

  • Difficulty breathing.
  • Shortness of breath. 
  • Inability to exercise or tiring easily.
  • Blue tinge to skin, lips, or nails.
  • Discomfort or difficulty breathing when lying on your back.

References

Canadian Cancer Society. Lung damage and chemotherapy. Found at: http://www.cancer.ca/en/cancer-information/diagnosis-and-treatment/chemotherapy-and-other-drug-therapies/chemotherapy/side-effects-of-chemotherapy/lung-damage-and-chemotherapy/?region=on

Fay M, Tan A, Fisher R, MacManus M, Wirth A, Ball D. Dose-volume histogram analysis as predictor of radiation pneumonitis in primary lung cancer patients treated with radiotherapy. International Journal of Radiation Oncology Biology Physics. 2005:61(5)1355-1363.

Siva S, MacManus M, Kron T, Best N, Smith J, Lobachevsky P, Ball D, Martin. A pattern of early radiation-induced inflammatory cytokine expression is associated with lung toxicity in patients with non-small cell lung cancer. PLoS One. 2014:9(10).

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