What Are Respiratory Complications?

Also known as pulmonary complications, respiratory problems may develop as a symptom or side effect in mesothelioma patients. When a patient has respiratory complications, they’re having trouble breathing at specific times due to damage in the area. Airways may be blocked by excessive tumor growth or from a side effect of anti-cancer treatments.

Breathing issues may be temporary, but other times problems can become chronic, or reoccurring. There are many reasons a person could develop pulmonary issues, and it all depends on the site of mesothelioma (or other cancer), type of treatment used, patient’s overall health, and stage of cancer among other reasons. If you think you’re experiencing chronic respiratory issues, make sure to reach out to your doctor. They’ll administer exams and tests to diagnose the issue properly.

Restrictive and Obstructive Lung Diseases

Two primary types of respiratory conditions occur in patients and they’re called restrictive and obstructive lung disease. When someone develops restrictive lung disease, it’s because illness or treatment has caused reduced total lung function and capacity. More specifically, those with restrictive lung disease cannot fully fill their lungs with air. The other type is called obstructive lung disease and occurs when disease or treatment causes blockage in the airways. This will make it difficult to breathe because airways are narrowed or damaged, which causes air to flow through slower and with more effort. Both restrictive and obstructive lung diseases can cause breathing difficulty and fatigue after simple tasks. Examples of restrictive lung diseases include pulmonary fibrosis, asbestosis, and pleural effusions to name a few. Obstructive lung diseases can encompass asthma and chronic obstructive pulmonary disease (COPD).

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Respiratory Complications from Mesothelioma

When a patient is diagnosed with cancer affecting the lungs or nearby tissues, they could develop pulmonary issues from living with the disease. Respiratory complications that mesothelioma tumors would cause depend on the type of mesothelioma. Pleural mesothelioma, cancer affecting tissue lining the lungs, is the type most likely to experience complications, but peritoneal mesothelioma, cancer in the abdomen tissue linings, and pericardial mesothelioma, cancer in the lining of the heart sac, may also hurt the respiratory system if tumors spread too far.

Asbestosis

More specific to cancer patients who’ve been exposed to asbestos, asbestosis is a respiratory complication that can occur when tiny asbestos fibers are lodged in the air sacs (alveoli) in one or both lungs and harms tissues. After many years of sustained damage, the lungs will become scarred, causing them to function poorly. This can cause crackling in the lungs when breathing, chest pain, and appetite loss. Asbestosis has a long latency period, meaning it can be several years before a person notices symptoms.

Chronic Obstructive Pulmonary Disease and Asthma

Chronic obstructive pulmonary disease (COPD) occurs when excess inflammation or harm to the lungs or airways causes obstruction or blockage that makes it more difficult to breathe. Since asthma causes resistance or difficulty breathing from obstruction, it’s also considered a type of COPD.

Pleural Effusion

Also called ‘water of the lungs’, pleural effusion happens when fluid builds up in the pleural space, or the tissue lining the lungs and chest area. When tumors or asbestos fibers irritate and cause inflammation in this area, excess fluid will be produced, causing pleural effusion. This is a common mesothelioma symptom. This illness can cause pain in the chest, fever, trouble breathing, and cough.

Pleural Plaques

Like pleural effusion, pleural plaques form when asbestos fibers cause inflammation or scarring in the tissues lining the lung and chest cavity. Pleural plaques are the most common symptom of asbestos exposure and happen when fibers harden and become hyalinized in the pleura. When tissues are hyalinized, they have deteriorated to the point of becoming translucent and solid like cartilage.

Collapsed Lung and Rounded Atelectasis

Tumors or asbestos fibers can cause a hardening of the lungs or tissue around the lung. This is called pleural thickening. When this happens, it can also cause the lung to collapse. More specifically, a collapsed lung happens when the lung cannot expand and collect air, causing breathing trouble. Sometimes only part of the lung will have trouble expanding, known as a partially collapsed lung, or rounded atelectasis. Both of these conditions appear more in patients with a history of asbestos exposure, especially rounded atelectasis.

Chronic Shortness of Breath

When tumors spread to the pleural lining around the lungs, this blockage can prevent the patient from taking deep and full breaths, causing chronic shortness of breath.

Respiratory Complications from Mesothelioma Treatment

Some anti-cancer treatments can also cause respiratory complications. One major complication of treatment is immunosuppression, or the immune system’s reduced ability to fight illness or infection. When the body gets an infection, several respiratory complications can arise from it. This can happen when the body has an adverse reaction to medications or medical procedures that cause harm to the lungs. Treatments that can cause complications include surgery, chemotherapy, and radiation.

Surgery

While these respiratory complications can also happen from other anti-cancer treatments, these are the most common side effects of surgery.

Pneumonia

An illness caused by a bacterial or viral infection in mesothelioma patients who are immunocompromised. When the air sacs in one or both lungs get inflamed or infected, pneumonia can occur. Symptoms include chronic, intense cough, sore throat, fever, chills, and trouble breathing among others.

Chemotherapy Medications

Medications from chemotherapy can cause respiratory issues because the chemotherapy drugs usually harm all cells and cannot distinguish between healthy and cancer cells.

Chemotherapy Pneumonitis

An illness that involves a noninfectious inflammation of the lungs. Sustained pneumonitis can also lead to further respiratory complications but may take a while to develop. Symptoms can include a dry cough, shortness of breath, fever, or chest pain.

Radiation Therapy

Higher doses of radiation beams to pleural mesothelioma patients can cause pulmonary trouble. This is because the radiation can also cause pneumonitis, which exacerbates other severe conditions.

Late Radiation Fibrosis

Pneumonitis from radiation can also cause late radiation fibrosis. This condition happens from prolonged high doses of radiation and symptoms may not appear for weeks or even years after treatment. Radiation fibrosis for cancer patients involves the intense scarring of tissue that can be caused by the radiation’s intense beams.

When to See Your Doctor

If breathing difficulties become too difficult to manage, call your doctor. They may recommend medicine or further treatment to relieve symptoms. Additionally, if there’s sharp chest pain, bluish coloration in lips or fingernails, reduced consciousness or alertness, or fatigue and weakness to the point of passing out, go to the doctor immediately or have someone take you. These could be symptoms of respiratory failure, which can be life-threatening if not taken care of quickly.

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