Care During Chemotherapy and Beyond
Lung and other Breathing Problems
WHAT DO THE LUNGS DO?
The lung is an organ found in your chest cavity. Each lung is divided into lobes.
On the left side, you have the left upper- and the left lower- lobe. On the right
side, there are 3 lobes: the right upper-, mid-, and lower lobe. A thin lining,
called the pleura, surrounds the lobes of the lung.
As you breathe, air moves down your windpipe (your trachea), through a tree-like
structure called the bronchi.
Near the end of the branches of the bronchi are the smaller bronchioles.
- At the end of the bronchioles are grape-like structures called alveoli, which open
and close during normal breathing.
- The lung is sterile. Your immune system works hard to prevent foreign invaders from
contaminating its environment.
- Anything that interrupts this system of respiration - including a blockage, such
as a foreign body, infection, inflammation, scarring, or injury, or even some
chemotherapy treatments - can cause you to experience
breathing problems. This page includes lung problems that you
may experience while you are undergoing treatment.
COMMON LUNG EXAMINATIONS
Brochoscopy - Using a thin, flexible tube, called a bronchoscope,
this procedure enables your doctor to look at the air passages to your lungs.
- If your breathing problems result in a bronchoscopy, your
healthcare provider may perform a washing, or a lavage, to collect cells from your
- To wash or lavage the lungs, the specialist will put a small amount of saline solution
down the tube. He or she will then remove the fluid, and examine the fluid for cells
under the microscope.
- Also, if the examiner sees a suspicious finding, such as a tumor, or possible infection,
he or she may take a sample (or biopsy) of the area for examination under the microscope.
You may have a bronchoscopy if:
- Your doctor or healthcare provider suspects that there is a foreign body in your
- Your breathing problems include coughing up blood
- There may be an abnormality in your lungs
- There is a growth or infection in your lungs or airways, which needs to be biopsied.
This will help your healthcare provider determine the best treatment possible for
- You may be required to fast (not eat) after midnight the day of the exam. After
your procedure, your jaw or throat may be a little sore.
- Your healthcare provider will give specific instructions to you before the procedure.
Make sure to ask any questions before your test is performed.
Chest X ray - This is a quick and painless procedure where a picture,
or an x-ray, will be taken to look at the internal structures of your chest. The
chest x-ray will look specifically at your lungs, heart, and ribs.
- This one-dimensional view may provide your healthcare provider with important information
about what is happening inside your chest wall, and lung region.
- Chest x-rays may be done routinely, if your healthcare provider wants to "watch"
a certain finding. It may also be done if you have symptoms of breathing problems,
such as a prolonged cough, or chest pain.
- If your healthcare provider or doctor thinks there may be a suspicious finding,
he or she may recommend that a more accurate test be done, such as a CAT scan.
Computerized Tomography (CT) Scan - A CT Scan is often recommended
to diagnose and identify chemotherapy-based breathing problems. This
test is more specific than plain x-rays, as a computer takes x-rays of your chest,
from different angles, to show a cross-sectional view of your chest and lungs. How
- As you lie on a movable table, a scanner inside of a machine moves around you. X-rays
are taken at different angles, as the computer records the pictures. The computer
then puts the pictures in a specific order, so that the specialist can interpret
- Sometimes, you may be given a contrast (dye) solution, either taken by mouth (oral)
or injected into a large vein (IV). This helps to improve the picture, and show
any abnormalities as the dye passes through your body. Your doctor may want you
to drink oral contrast if he or she wants to examine your abdomen or pelvis at the
same time the chest is examined.
- You may be required to fast (not eat) after midnight the day of the exam. Your healthcare
provider will give specific instructions to you.
Lung Scan (Ventilation-Perfusion scan [VQ]) - Your doctor or healthcare
provider will order this test if he or she suspects that you may have developed
a blood clot in your lungs, called a pulmonary embolism (PE). You may have experienced
shortness of breath, or chest discomfort, which may signify that a blood clot may
- A radioactive dye is injected into your vein. A camera photographs how the blood
is flowing through your lungs.
- If there is a blockage in the flow of blood, this may mean that you have a blood
- If a blood clot is present, your doctor or healthcare provider may suggest that
you be hospitalized so that you can receive a blood thinner in the vein (IV), and
be closely monitored.
Pulmonary Function Test (PFT) - If you experience breathing
problems during chemotherapy, a pulmonary function test may be recommended.
This test shows how well your lung function is. It may also be called spirometry.
Your healthcare provider may order many tests, all done at once, which all show
how well you are moving air through your lungs.
You will be asked to blow into a tube (a spirometer), as forcefully as possible.
This amount of air that you blow is then recorded. The machine will measure your:
- Forced Vital Capacity (FVC) - this is the maximum amount (in volume)
of air that can be forcefully exhaled (blown out) with a single breath, which indicates
the size of your lungs.
- Forced expiratory volume (FEV1) - This is the amount of air that
is forcefully blown out of your lungs in one second.
- By looking at the ratio of FVC to FEV1, your healthcare provider may have an indication
of your lung functioning. This may help to diagnose many short-term and long-term
- You may receive this exam if you are experiencing shortness of breath at rest, or
when you perform certain activities. You may also receive this test if you are about
to undergo a certain type of chemotherapy that may cause damage to your lungs.
- Sputum Culture - your doctor or healthcare provider will ask you
to cough up a sample of your sputum or phlegm to send to the microbiology lab.
- is best to submit a sputum specimen in the early morning.
- Normal bacteria that are in your mouth may contaminate the sample, so it will be
easier to see if lung bacteria are present following a deep cough.
- The bacteria that are present in your sample will help your healthcare provider
determine the best treatment for you.
Note: We strongly encourage you to talk with your health
care professional about your specific medical condition and treatments. The information
contained in this website is meant to be helpful and educational, but is not a substitute
for medical advice.
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