Chemocare.com

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 lungs.
  • 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 lungs
  • 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.
    • 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 it works:

  • 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 the findings.
  • 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 be present.

  • 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 clot.
  • 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 lung conditions.
    • 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.