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Certain chemotherapy drugs and radiation therapy to the chest cavity can damage the heart. The risk of heart damage increases with the age of the patient and the dosage of medication received. Chemotherapy medications that may cause heart damage include anthracyclines such as doxorubicin and epirubicin, and others such as cyclophosphamide, paclitaxel, and trastuzumab. These medications can cause inflammation of the heart muscle (myocarditis), congestive heart failure, arrhythmias, coronary artery disease, problems with the heart valves, and problems with the heart's electrical system. These conditions can increase the risk of heart attack and stroke. Ask your physician if your treatment plan puts you at risk for heart damage.
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Certain chemotherapy drugs and radiation therapy to the chest cavity can damage the lungs. Medications most likely to damage the lungs include: bleomycin, carmustine, prednisone, dexamethasone, methotrexate, and cyclophosphamide. These medications can cause inflammation (pneumonitis) and scarring (pulmonary fibrosis) of the lung tissue, which can cause difficulty breathing, shortness of breath, coughing, wheezing, and fatigue. Pneumonitis is a condition in which the alveoli become inflamed, making it difficult to breath and absorb oxygen into the bloodstream. Pulmonary fibrosis is a condition in which scar tissue forms on the lungs, causing them to lose elasticity and making it difficult for the lungs to expand and fill with air properly. Ask your physician if your treatment plan puts you at risk for lung damage.
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Osteoporosis is a condition that causes the bones to lose density and become weak and fragile. Many people, especially women, develop osteoporosis as they get older. This disease can greatly increase the risk of bone fractures and breaks. Certain chemotherapy drugs can decrease the amount of calcium in the body, and accelerate osteoporosis and bone thinning. Hormone therapy, radiation therapy, and steroid medications may also cause bone problems. Ask you physician if you are at risk for bone damage from your cancer treatments.
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The liver is an organ whose primary functions include releasing bile into the intestines to aid in digestion, breaking down and storing nutrients, clearing medications from the body and removing toxic substances from the blood. Certain chemotherapy drugs can place added stress on the liver, which can eventually damage the liver and prevent it from functioning properly. Symptoms of liver damage may include dark urine, yellow skin and eyes (jaundice), abdominal pain, swelling in the abdomen, weakness, and fatigue. Ask your doctor if your cancer medications put you at risk for liver damage, and what steps you may take to prevent this complication.
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Your kidneys are two fist-sized, bean-shaped organs located in the back of your torso, just above your waist. Your kidneys are responsible for filtering waste and excess water from your blood and turning it into urine. Certain cancer medications, including chemotherapies and biological therapies, can damage the kidneys and cause this excess water and waste to build up in the body and cause the kidneys to stop functioning properly. The risk of kidney damage is higher in patients with comorbidities such as pre-existing kidney damage, diabetes, and heart disease. Symptoms of kidney damage may include dark urine, pain when urinating, blood in the urine, fatigue, and muscle weakness. Cancer medications that may cause kidney damage include cisplatin, interleukin-2, cytarabine, methotrexate, carboplatin, and others. Ask your physician if you are at risk for kidney damage and what steps you may take to prevent/inhibit this damage.
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The thyroid gland is a butterfly-shaped gland in the front of the neck, just below the Adam's apple, that wraps around the front of the windpipe. The thyroid gland produces hormones that regulate heart rate, blood pressure, body temperature, and energy metabolism. Radiation therapy to the head, neck, or brain can damage the thyroid gland and cause hypothyroidism, a condition in which the thyroid gland does not produce enough thyroid hormone. Hypothyroidism causes the body's energy metabolism to slow down, which can cause symptoms such as fatigue, depression, weight gain, and difficulty concentrating. About half of all patients who receive radiation therapy to the neck eventually develop hypothyroidism. Many systemic cancer medications can also cause thyroid dysfunction, including interferon-alpha, interleukin-2, and Tyrosine Kinase Inhibitors (TKIs) such as sinitinib and imatinib.
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Certain cancer treatments can increase the risk of developing secondary cancers later in life, especially if you were treated for cancer as a child. Alkylating agents such as cyclophosphamide, cisplatin, and carboplatin, anthracyclines such as doxurubicin and epirubicin, and other chemotherapy medications carry the greatest risk. Acute Myeloid Leukemia (AML) is the most common secondary cancer caused by these medications. MDS and ALL may also occur in some cases. Radiation therapy can also increase risk of developing a secondary cancer. The most common cancer types linked to radiation therapy are leukemia and solid tumors of the thyroid, skin, bone, breast, and lung. The risk depends on the radiation dosage, the area of treatment, and the patient's age at time of treatment.
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