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Respiratory System

Key Points

  • Lung late effects are more likely to occur after treatment for certain childhood cancers.
  • Certain types of chemotherapy and radiation to the lungs increase the risk of lung late effects.
  • Late effects that affect the lungs may cause certain health problems.
  • Possible signs and symptoms of lung late effects include trouble breathing and cough.
  • Certain tests and procedures are used to detect (find) and diagnose health problems in the lung.
  • Health habits that promote healthy lungs are important for survivors of childhood cancer.

Lung late effects are more likely to occur after treatment for certain childhood cancers.

Treatment for these and other childhood cancers may cause lung late effects :

Certain types of chemotherapy and radiation to the lungs increase the risk of lung late effects.

The risk of health problems that affect the lungs increases after treatment with the following:

  • Surgery to remove all or part of the lung or chest wall.
  • Chemotherapy. In survivors treated with chemotherapy, such as bleomycin, busulfan, carmustine, or lomustine, and radiation therapy to the chest, there is a high risk of lung damage.
  • Radiation therapy to the chest. In survivors who had radiation to the chest, the damage to the lungs and chest wall depends on the radiation dose, whether all or part of the lungs and chest wall received radiation, whether the radiation was given in small, divided daily doses, and the child's age at treatment.
  • Total-body irradiation (TBI) or certain types of chemotherapy before a stem cell transplant.

The risk of lung late effects is greater in childhood cancer survivors who are treated with a combination of surgery, chemotherapy, and/or radiation therapy. The risk is also increased in survivors who have a history of the following:

Late effects that affect the lungs may cause certain health problems.

Lung late effects and related health problems include the following:

Possible signs and symptoms of lung late effects include trouble breathing and cough.

These and other signs and symptoms may be caused by lung late effects or by other conditions :

  • Dyspnea (shortness of breath), especially when being active.
  • Wheezing.
  • Fever.
  • Dry cough.
  • Congestion (a feeling of fullness in the lungs from extra mucus).
  • Feeling tired.

Talk to your child's doctor if your child has any of these problems.

Lung late effects in childhood cancer survivors may occur slowly over time or there may be no symptoms. Sometimes lung damage can be detected only by imaging or pulmonary function testing. Lung late effects may improve over time.

Certain tests and procedures are used to detect (find) and diagnose health problems in the lung.

These and other tests and procedures may be used to detect or diagnose lung late effects:

  • Physical exam and history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.
  • Chest x-ray: An x-ray of the organs and bones inside the chest. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.
  • Pulmonary function test (PFT): A test to see how well the lungs are working. It measures how much air the lungs can hold and how quickly air moves into and out of the lungs. It also measures how much oxygen is used and how much carbon dioxide is given off during breathing. This is also called lung function test.

Talk to your child's doctor about whether your child needs to have tests and procedures to check for signs of lung late effects. If tests are needed, find out how often they should be done.

Health habits that promote healthy lungs are important for survivors of childhood cancer.

Childhood cancer survivors with lung late effects should take care to protect their health, including:

  • Not smoking.
  • Getting vaccines for flu and pneumococcus.

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