Written by Karen Selby, RN | Medically Reviewed By Dr. Jeffrey Velotta | Edited By Walter Pacheco | Last Update: June 27, 2024

What Causes Respiratory Complications?

Respiratory complications stem from tumors growing on the lining of the lungs. Other respiratory complications include shortness of breath and pleural effusion. These mesothelioma symptoms worsen as the cancer progresses to later stages.

Fluid buildup in the lining of the lungs, also known as pleural effusions, can lead to restricting the lungs from filling with air, which causes trouble breathing and, overtime, lung infections.

Surgery, chemotherapy and radiation therapy may cause respiratory complications.

Unfortunately, patients cannot avoid or reduce the risk of respiratory complications. Breathing exercises, supplemental oxygen and palliative surgical procedures can ease these symptoms.

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

Respiratory Complications Caused by Mesothelioma

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

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

As mesothelioma progresses throughout the chest, multiple symptoms can occur, and there is a higher risk for severe complications.

Shortness of Breath

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

Treatments: Breathing techniques and supplemental oxygen can help manage shortness of breath. Ask your oncologist about 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. A 2021 clinical research study noted that pleural effusions affect more than 1.5 million patients annually in the U.S.

Treatments: Most patients with pleural effusions receive thoracentesis, a procedure that drains fluid from the pleural space to relieve lung pressure. Doctors may also recommend pleurodesis, a longer-term solution for recurring pleural effusions.

Rounded Atelectasis

Rounded atelectasis, or folded lung, is a partially collapsed lung. Pleural effusion and pleural thickening trigger this respiratory condition. Asbestos exposure accounts for 29% to 86% of cases.

Treatments: Physical therapies or surgical procedures can address the 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.

Survivor Story
Survivor Story
Virginia Beach Pleural Mesothelioma

Respiratory Issues Prompted Palliative Care

Virginia Beach became frightened by a sudden shortness of breath, prompting her oncologist to recommend hospice and palliative care. A nurse and a social worker started visiting her regularly. “After a while, the doctor told me my lungs were clear. I didn’t need them to do much, but the nurse did help me understand my iPad, and how to use it better,” she laughed. “That was a big help to me.”

Read Virginia’s Story
Dr. Jacques Fontaine and Dr. Andrea Wolf
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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 have an increased risk of developing pneumonia and respiratory infections. According to a 2017 study published in the 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 happens when the lung’s tiny air sacs fill with excess fluid. It can develop after specific treatments, such as surgery, talc pleurodesis or 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 before they cause complications can improve treatment outcomes.

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