Written By: Karen Selby, RN,
Last modified: February 12, 2021

What Causes Respiratory Complications?

As tumors on the lining of the lungs grow, they affect lung function. Some of the most common mesothelioma symptoms, such as shortness of breath and pleural effusion, are respiratory complications caused by the cancer.

These complications become increasingly common as mesothelioma on the pleura progresses to later stages.

Respiratory complications can also result from certain mesothelioma treatments, including surgery, chemotherapy and radiation therapy.

There isn’t anything specific mesothelioma patients can do to avoid or reduce the risk of respiratory complications. However, breathing exercises, supplemental oxygen and palliative surgical procedures can ease these symptoms to improve quality of life.

Patients should report any changes in lung function or worsening chest pain to catch respiratory complications early.

Doctor Tip:
The best way to minimize the risk of respiratory complications is to practice standard sanitation techniques (hand washing, covering your mouth when you cough, etc.) and stop activities, such as smoking, that cause lung harm. Also, continued exercise is helpful in maintaining lung strength. — Dr. Nathan Lott, pulmonary and critical care physician, Baylor Scott & White Health in Texas

Respiratory Complications Caused by Mesothelioma

Pleural mesothelioma can cause a variety of respiratory complications such as shortness of breath, pleural effusion and lung collapse.

Shortness of Breath

Dyspnea, or shortness of breath, is one of the most common respiratory complications of mesothelioma. In a 2011 study of 238 pleural mesothelioma patients published in Industrial Health, 79% reported shortness of breath.

Treatments: Breathing techniques and supplemental oxygen help patients manage shortness of breath. Ask your oncologist about recommended breathing exercises or for a referral to a pulmonologist.

Pleural Effusion

Pleural effusion is a buildup of fluid between the layers of the pleural lining. The excess fluid presses against the lungs and contributes to breathing difficulties.

Approximately 90% of pleural mesothelioma patients get effusions.

Treatments: Most patients with pleural effusions receive a thoracentesis, which drains the fluid from the pleural space to relieve pressure on the lungs and ease breathing. Doctors may also recommend a pleurodesis, a longer-term solution for recurring pleural effusions.

Rounded Atelectasis

Rounded atelectasis, or folded lung, is a partially collapsed lung. This respiratory complication is commonly triggered by pleural effusion and pleural thickening. Asbestos exposure accounts for 29% to 86% of cases.

Treatments: Physical therapies or surgical procedures can be used to address the root cause.

Collapsed Lung

Pneumothorax, or collapsed lung, is an uncommon respiratory complication in mesothelioma patients. It happens when air enters the pleural space between the lung and chest wall. Less than 10% of patients experience a spontaneous pneumothorax.

Treatments: Physical therapies and surgical procedures may help release trapped air.

Pleural mesothelioma symptoms by frequency
Frequency of symptoms reported in a 2011 study of 221 pleural patients.

Respiratory Complications from Mesothelioma Treatment

Common pleural mesothelioma treatments, such as surgery, chemotherapy and radiation, therapy can lead to new or worsening respiratory complications.

Working with a team of mesothelioma specialists can help reduce these side effects. Doctors who understand this cancer also know common complications of treatments and how best to address them.

Pneumonia and Respiratory Infections

Pleural mesothelioma patients are at an increased risk of developing pneumonia and respiratory infections. According to a 2017 study published in Annals of Translational Medicine, approximately 2% of pleural patients who undergo surgery develop pneumonia.

Treatments: Doctors prescribe antibiotics and antivirals to treat pneumonia and respiratory infections.

Respiratory Distress and Failure

Acute respiratory distress syndrome (ARDS) happens when the tiny air sacs of the lungs fill with excess fluid. It can develop after certain treatments, such as surgery or talc pleurodesis, or as a result of pneumonia.

Treatments: Doctors treat ARDS with mechanical ventilation (sometimes called an artificial lung). Around 50% of all ARDS patients experience respiratory failure within 10 days. Most deaths from pleural mesothelioma tend to be a result of respiratory failure.

Other Respiratory Complications of Surgery

  • Pulmonary edema: Excess fluid in the lungs
  • Pulmonary embolus: Blood clotting in the lungs
  • Bronchial air leaks: Air leaking from lungs
  • Mediastinal shift: The shifting of organs inside the chest
  • Hemothorax: Internal bleeding around lungs
  • Acute respiratory distress syndrome: Lung failure

Possible Respiratory Complications of Chemotherapy

  • Cisplatin: May cause eosinophilic pneumonia, known as accumulation of a certain type of white blood cells in the lungs.
  • Pemetrexed (Alimta): May cause pneumonitis (lung inflammation), diffuse alveolar hemorrhage (bleeding in the lungs) and ARDS.
  • Gemcitabine: May cause pneumonitis, eosinophilic pneumonia and pulmonary fibrosis, also known as lung tissue scarring.

Respiratory Complications of Radiation Therapy

  • Radiation pneumonitis (lung inflammation)
  • Chronic radiation fibrosis (lung tissue scarring)

Call your oncologist immediately if you experience any changes in respiratory function. Catching respiratory complications early improves treatment outcomes.


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