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\nCardiopulmonary syndromes are conditions of the heart and lung that may be caused by cancer or by other health problems. Five cardiopulmonary syndromes that may be caused by cancer are covered in this summary:
\nThis summary is about cardiopulmonary syndromes in adults and children with cancer. Section titles show when the information is about children.
\nDyspnea is the feeling that you can't catch your breath or you can't breathe in enough air. It also may be called shortness of breath, breathlessness, or air hunger. In cancer patients, dyspnea can be caused by the following:
\nDiagnostic tests and procedures include the following:
\nTreatment may include the following:
\nThe treatment of dyspnea depends on its cause, as follows:
\nIf the dyspnea is caused by: | \nThen the treatment may be: | \n
---|---|
Tumor blocking the large or small airways in the chest or lung | \n\u2022 Radiation therapy. | \n
\u2022 Chemotherapy, for tumors that usually respond quickly to this treatment. | \n|
\u2022 Laser surgery to remove the tumor. | \n|
\u2022 Cauterization of tumors. | \n|
\u2022 Stent placement to keep airway open. | \n|
Pleural effusion | \n\u2022 Removal of the extra fluid around the lung using a needle or chest drain. | \n
Pericardial effusion | \n\u2022 Removal of the extra fluid around the heart using a needle. | \n
\u2022 Intrapericardial chemotherapy. | \n|
\u2022 Surgery. | \n|
Ascites | \n\u2022 Removal of the extra fluid in the abdominal cavity using a needle. | \n
Carcinomatous lymphangitis | \n\u2022 Steroid therapy. | \n
\u2022 Chemotherapy, for tumors that usually respond quickly to this treatment. | \n|
Superior vena cava syndrome | \n\u2022 Chemotherapy, for tumors that usually respond quickly to this treatment. | \n
\u2022 Radiation therapy. | \n|
\u2022 Surgery to place a stent in the superior vena cava to keep it open. | \n|
\u2022 Opioids and/or steroid therapy. | \n|
Chest infections | \n\u2022 Antibiotics. | \n
\u2022 Breathing treatments. | \n|
Pulmonary embolism | \n\u2022 Anticoagulants. | \n
Bronchospasms or chronic obstructive pulmonary disease | \n\u2022 Bronchodilators. | \n
\u2022 Inhaled steroids. | \n|
Postradiation bronchiolitis obliterans | \n\u2022 Steroid therapy. | \n
Heart failure | \n\u2022 Diuretics and other heart medicines. | \n
Anemia | \n\u2022 Blood transfusion | \n
Checkpoint inhibitor immunotherapy\u2013related pneumonitis | \n\u2022 Withholding drug therapy. | \n
\u2022 Corticosteroids. | \n|
\u2022 Close follow-up. | \n
Treatment to control the signs and symptoms of dyspnea may include the following:
\nChronic cough may cause pain, trouble sleeping, dyspnea, or fatigue. The causes of chronic coughing are almost the same as the causes of dyspnea. See Dyspnea section for list of causes.
\nTreatments may include:
\nMedicines may include:
\nThe pleural cavity is the space between the pleura (thin layer of tissue) that covers the outer surface of each lung and lines the inner wall of the chest cavity. Pleural tissue usually makes a small amount of fluid that helps the lungs move smoothly in the chest while a person is breathing. A pleural effusion is extra fluid in the pleural cavity. The fluid presses on the lungs and makes it hard to breathe.
\nA pleural effusion may be malignant (caused by cancer) or nonmalignant (caused by a condition that is not cancer). Malignant pleural effusion is a common problem for patients who have certain cancers. Lung cancer, breast cancer, lymphoma, and leukemia cause most malignant effusions.
\nPleural effusion also may be caused by radiation therapy, chemotherapy, a collapsed lung, or cancer that has spread to lymph nodes. Some cancer patients have conditions such as congestive heart failure, pneumonia, blood clot in the lung, or poor nutrition that may lead to a pleural effusion.
\nThese and other signs and symptoms may be caused by a pleural effusion. Talk to your doctor if you have any of the following problems:
\nTreatment for a malignant pleural effusion is different from treatment for a nonmalignant effusion, so the right diagnosis is important. Diagnostic tests used to find the cause of the pleural effusion include the following:
\nThe type of cancer, previous treatment for cancer, and your choices also are important in planning treatment.
\nA malignant pleural effusion often occurs in cancer that is advanced, cannot be removed by surgery, or continues to grow or spread during treatment. It is also common during the last few weeks of life. The goal of treatment is usually palliative, to relieve signs and symptoms and improve quality of life.
\nTreatment of the signs and symptoms of malignant pleural effusion includes the following:
\nPericardial effusion is extra fluid inside the sac that surrounds the heart. The extra fluid causes pressure on the heart, which stops it from pumping blood normally. If fluid builds up, a condition called cardiac tamponade may occur. In cardiac tamponade, the heart cannot pump enough blood to the rest of the body. This is life-threatening and must be treated right away.
\nA pericardial effusion may be malignant (caused by cancer) or nonmalignant (caused by a condition that is not cancer). Malignant pericardial effusion is common in lung cancer, breast cancer, melanoma, lymphoma, and leukemia patients. Pericarditis (swelling of tissues around the heart), a heart attack, hypothyroidism, or systemic lupus erythematosus are examples of nonmalignant causes of pericardial effusion. Radiation therapy or chemotherapy may cause pericarditis, leading to pericardial effusion.
\nAt first, a pericardial effusion may not cause any signs or symptoms. These and other signs and symptoms may be caused by a pericardial effusion or cardiac tamponade. Check with your doctor if you have any of the following:
\n \nPericardial effusion usually occurs in advanced cancer or in the last few weeks of life. During these times, it may be more important to relieve the symptoms than to diagnose the condition. However, in some cases, the following tests and procedures may be used to diagnose pericardial effusion:
\nThe goal of treatment is usually palliative, to relieve symptoms and improve quality of life. If a malignant pericardial effusion is severe, it is usually controlled by draining the fluid.
\nTreatment options include the following:
\nThe superior vena cava is a major vein that leads to the heart. The heart is divided into four parts. The right and left atrium make up the top parts of the heart and the right and left ventricle make up the bottom parts of the heart. The right atrium of the heart receives blood from two major veins:
\nDifferent conditions can slow the flow of blood through the superior vena cava. These include a tumor in the chest, nearby lymph nodes that are swollen (from cancer), or a blood clot in the superior vena cava. The vein may become completely blocked. Sometimes, smaller veins in the area become larger and take over for the superior vena cava if it is blocked, but this takes time. Superior vena cava syndrome (SVCS) is the group of signs and symptoms that occur when this vein is partly blocked.
\nSVCS is usually caused by cancer. In adults, SVCS is most common in the following types of cancer:
\nLess common causes of SVCS include:
\nThe signs and symptoms of SVCS are more severe if the vein becomes blocked quickly. This is because the other veins in the area do not have time to widen and take over the blood flow that cannot pass through the superior vena cava.
\nThe most common signs are:
\nLess common signs and symptoms include the following:
\nThe following tests may be done to diagnose SVCS and find the blockage:
\nIt is important to find out the cause of SVCS before starting treatment. The type of cancer can affect the type of treatment needed. Unless the airway is blocked or the brain is swelling, waiting to start treatment while a diagnosis is made usually causes no problem in adults. If doctors think lung cancer is causing the problem, a sputum sample may be taken and a biopsy may be done.
\nTreatment for SCVS caused by cancer depends on the following:
\n \nThe following may be used to relieve signs or symptoms and keep the patient comfortable:
\nThe signs and symptoms of superior vena cava syndrome can be upsetting. It is important that you and your family ask questions about superior vena cava syndrome and how to treat it. This can help relieve anxiety about signs and symptoms such as swelling, trouble swallowing, coughing, and hoarseness.
\nIf you have advanced cancer you may decide not to have any more treatment. Palliative care can help keep you comfortable by relieving signs and symptoms to improve your quality of life.
\nSuperior vena cava syndrome (SVCS) is rare in children, but when it occurs, it can be life-threatening. In adults, the windpipe is stiff, but in children, it is softer and can more easily be squeezed shut or blocked. A child's windpipe is narrow, so any amount of swelling can cause breathing problems. Squeezing of the trachea is called superior mediastinal syndrome (SMS). Because SVCS and SMS usually happen together in children, the two syndromes are considered to be the same.
\nCommon signs and symptoms include the following:
\nThere are other less common but more serious signs and symptoms:
\n \nSVCS in children is rare. The most common cause is non-Hodgkin lymphoma. As in adults, SVCS may also be caused by a blood clot that forms during use of an intravenous catheter (flexible tube used to put fluids into or take blood out of a vein) in the superior vena cava.
\nA physical exam, chest x-ray, and medical history are usually all that are needed to diagnose superior vena cava syndrome in children. Even if doctors think cancer is causing SVCS, a biopsy may not be done. This is because the lungs and heart of a child with SVCS may not be able to handle the anesthesia needed. Other imaging tests may be done to help find out if anesthesia can be safely used. In most cases, treatment for SVCS will begin before a diagnosis of cancer is made.
\nThere are several ways to treat SVCS in children.
\nUse our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available.
\nPhysician Data Query (PDQ) is the National Cancer Institute's (NCI's) comprehensive cancer information database. The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries come in two versions. The health professional versions have detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions have cancer information that is accurate and up to date and most versions are also available in Spanish.
\nPDQ is a service of the NCI. The NCI is part of the National Institutes of Health (NIH). NIH is the federal government\u2019s center of biomedical research. The PDQ summaries are based on an independent review of the medical literature. They are not policy statements of the NCI or the NIH.
\nThis PDQ cancer information summary has current information about the pathophysiology and treatment of cardiopulmonary syndromes, including dyspnea, malignant pleural effusion, malignant pericardial effusion, and superior vena cava syndrome. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.
\nEditorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer. The summaries are reviewed regularly and changes are made when there is new information. The date on each summary (\"Updated\") is the date of the most recent change.
\nThe information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the PDQ Supportive and Palliative Care Editorial Board.
\nA clinical trial is a study to answer a scientific question, such as whether one treatment is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about the effects of a new treatment and how well it works. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become \"standard.\" Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.
\nClinical trials can be found online at NCI's website. For more information, call the Cancer Information Service (CIS), NCI's contact center, at 1-800-4-CANCER (1-800-422-6237).
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\nThe best way to cite this PDQ summary is:
\nPDQ\u00ae Supportive and Palliative Care Editorial Board. PDQ Cardiopulmonary Syndromes. Bethesda, MD: National Cancer Institute. Updated <MM/DD/YYYY>. Available at: https://www.cancer.gov/about-cancer/treatment/side-effects/cardiopulmonary-pdq. Accessed <MM/DD/YYYY>. [PMID: 26389457]
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\nUpdated:
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