Lung Health After Childhood Cancer


The lungs supply needed oxygen to the body. But treatment for childhood cancer can sometimes damage the lungs. Here is what you need to know to assess your risk for lung problems and to help keep your lungs healthy.

Am I at Risk?

If you had any of the following cancer treatments, you may be at risk for developing lung problems.

  • Certain chemotherapy drugs including, belomycin (see related Health Link: "Bleomycin Alert"), carmustine (also called BCNU), lomustine (also called CCNU), or busulfan
  • Radiation to the chest or whole body
  • Surgery to the chest or lung (this does not include surgery to have a central line placed)
  • Bone marrow or stem cell transplant from a donor other than yourself that resulted in chronic graft-versus-host-disease
  • Also, a type of chemotherapy drug called anthracyclines can damage your heart, which can contribute to lung problems. This is especially the case if they were given with bleomycin, carmustine, lomustine, or radiation.

Other factors that can increase your risk for lung problems are:

  • younger age when you were treated for cancer
  • history of lung infections, asthma, or other lung problems
  • tobacco use or exposure to second-hand smoke

Lung problems that can develop as a result of these treatments include scarring of the lungs, repeated lung infections, swelling of the lung tissue and airways, rupture of the air sacs in the lungs, and thickening and blockage of the airways in the lungs.

What Are the Symptoms of Lung Problems?

Symptoms of lung problems may include:

  • shortness of breath;
  • frequent coughing, wheezing, or both;
  • chest pain; and
  • frequent lung infections, such as bronchitis or pneumonia.

Fatigue or shortness of breath during mild exercise is sometimes an early symptom of lung damage.

What Can I Do to Keep My Lungs Healthy?

There are many ways to help lower your chance for lung problems, including talking with your doctor, not smoking, and adopting a healthy lifestyle.

See Your Doctor 

As a childhood cancer survivor you should have a health check-up every year. In addition, you should undergo a chest x-ray and pulmonary function tests at least two years after you finish your cancer treatment to check for any lung problems. Further testing may be needed based on the results of the tests.

If you are at risk for lung problems, talk with your doctor about getting pneumonia and flu vaccines. Also, 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.

Don't Smoke 

The most important lifestyle change that you can make is to not smoke. Family, friends, and your doctor are great resources for quitting.

To request information by phone on how to quit smoking, call these organizations:

  • American Cancer Society: 1-800-ACS-2345
  • American Heart Association: 1-800-AHA-USA1
  • American Lung Association: 1-800-LUNG-USA
  • National Cancer Institute: 1-877-44U-QUIT

Visit these websites for online information on how to quit smoking:

  • The Centers for Disease Control and Prevention (www.cdc.gov/tobacco/) provides guides for how to quit smoking.
  • The American Lung Association (http://www.ffsonline.org/) offers a free online program called "Freedom from Smoking Online."
  • Smokefree.gov (http://www.smokefree.gov) provides free, accurate, evidence-based information and professional assistance to help support the immediate and long-term needs of people trying to quit smoking.

Adopt a Healthy Lifestyle 

Other lifestyle changes that can help prevent lung problems include these:

  • Avoid second-hand smoke.
  • Get regular physical exercise.
  • Avoid breathing toxic fumes from chemicals, solvents, and paints.
  • Follow the safety rules at your workplace, such as using protective ventilators.
  • Report any unsafe working conditions to the Occupational Safety and Health Administration.

Where Can I Find More Information on Lung Health?

You can find more information on the lungs and how to keep them healthy from the National Heart, Lung and Blood Institute's website at www.nhlbi.nih.gov/health/public/lung/.

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