Pulmonary System

Pulmonary disease is a highly prevalent cause of premature morbidity and mortality in long-term childhood cancer survivors. Pulmonary toxicity is frequently reported in survivors of Hodgkin lymphoma, germ cell tumors, acute lymphoblastic lymphoma and metastatic Wilms tumor survivors, as the chemotherapy, radiation and surgeries used to treat these pediatric cancer (among others) can result in permanent lung damage. This damage can manifest as acute pneumonitis, late onset fibrosis, and structurally induced dysfunction from developmental abnormalities due to impaired growth of the thorax attributable to surgery or radiation. The cumulative incidence of pulmonary problems after childhood cancer increases with time since diagnosis, as with other late-effects, suggesting that survivors are at an elevated risk of developing later-onset pulmonary morbidities as they age.