Bleomycin Alert

The lungs supply needed oxygen to the body. But treatment for childhood cancer, such as bleomycin, can sometimes damage the lungs and lead to problems many years later.

Am I at Risk?

Several factors can raise your risk for lung problems if you received bleomycin, including:

  • high total doses of bleomycin
  • radiation to the chest, lungs, or whole body
  • treatment with other chemotherapy drugs that can damage the lungs (see related Health Link: “Pulmonary Health”)
  • exposure to high oxygen levels (such as during general anesthesia or SCUBA diving)
  • smoking

What Lung Problems Can Occur?

Survivors who received bleomycin during treatment for childhood cancer can develop these lung problems many years after treatment: 

Interstitial Pneumonitis 

This condition occurs when the thin layer of tissue between the air sacs in the lungs is inflamed. Inflammation can worsen if you have an infection, such as pneumonia. If you received bleomycin, interstitial pneumonitis can occur after exposure to toxic fumes, tobacco, or high levels of oxygen.

Pulmonary Fibrosis 

This condition occurs when scar tissue forms in the small air sacs of the lungs. This scarring can worsen over time and can sometimes lead to early heart failure.

Acute Respiratory Distress Syndrome (ARDS) 

This condition occurs when the small air sacs of the lung are damaged and can no longer provide oxygen to the body. People who received bleomycin may be at risk for ARDS, most often as a result of receiving high levels of oxygen and intravenous fluids during surgery. Although the risk for ARDS is low, before any medical procedures that require oxygen or general anesthesia you should tell your surgeon, anesthesiologist, and other healthcare providers if you received bleomycin for treatment of childhood cancer.

What Can I Do to Keep My Lungs Healthy?

If you received treatment with bleomycin, you should:

  • Avoid SCUBA diving until you have a complete check-up and are told by a lung doctor (pulmonologist) that it is safe for you.
  • Tell your surgeon, anesthesiologist, and other healthcare providers about your medical history before any scheduled procedures that may require oxygen.
  • Avoid breathing high concentrations of oxygen when possible, especially over several hours. If you need oxygen, you should receive the lowest concentrations necessary.
  • Get the pneumonia vaccine and yearly flu vaccines.
  • Don’t smoke. If you do, talk with your doctor about how to quit.

For more information about your lungs and how to keep them healthy, read the related Health Link: “Lung Health after Childhood Cancer.”

Flesch-Kincaid Grade Level: 9.7

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