What to Watch For

CURE, Spring 2008, Volume 7, Issue 1

Heart-lung complications are more likely in survivors of certain cancers—breast, lymphoma, testicular, lung—and who received certain treatments

Heart-lung complications are more likely in survivors of these cancers:

>Breast cancer

> Lymphoma

> Testicular cancer

> Lung cancer

The treatments listed below have been found to sometimes be associated with the listed conditions (in many instances, these side effects are rare):

> Anthracyclines (Adriamycin/doxorubicin and Ellence/epirubicin): inflammation of heart, cardiomyopathy, heart failure

> Cytoxan (cyclophosphamide): inflammation of heart, cardiomyopathy, heart failure

> Cisplatin: inflammation of heart, cardiomyopathy, heart failure

> Taxanes (Taxol/paclitaxel and Taxotere/docetaxel): inflammation of heart, cardiomyopathy, heart failure

> Herceptin (trastuzumab): lung inflammation, heart failure

> Blenoxane (bleomycin): lung scarring, inflammation, pneumonia

> Carmustine: lung scarring, inflammation, pneumonia

> Methotrexate: lung scarring, inflammation

Radiation affecting heart:

> inflammation of the sac surrounding the heart, scarring or inflammation, valve damage, irregular heart rate, coronary artery disease

Radiation affecting lungs:

> lung scarring, pneumonitis, possibly progressive pulmonary fibrosis; late complications include right-side heart failure and respiratory failure

Bone marrow or stem-cell transplantation:

> interstitial pneumonitis: a group of disorders related to the sacs in the lungs where air exchange takes place; late complications include idiopathic pneumonia syndrome, injury to the sacs where air exchange takes place in the lungs; and bronchiolitis obliterans, inflammation of the bronchioles, small airways in the lung

Notify the doctor if you develop:

> Fatigue

> Shortness of breath

> Swelling of the ankles or feet

Experts do not recommend routine screening tests, beyond an annual physical exam with a blood pressure check and blood work to check cholesterol levels.

SOURCES: American Society of Clinical Oncology “Clinical Evidence Review on the Ongoing Care of Adult Cancer Survivors: Cardiac and Pulmonary Late Effects”; Institute of Medicine, “From Cancer Patient to Cancer Survivor: Lost in Transition”