Pulmonary Hypertension and Cancer: Etiology, Diagnosis, and Management

Abstract

Pulmonary hypertension is caused by cancer and its therapeutic agents including chemotherapy, radiotherapy, and even the targeted therapies. Ironically, some of the cancer therapies that cause one type of pulmonary hypertension (PH) could potentially be employed in the treatment of another PH type. Greater awareness on the role of cancer therapeutic agents in causing PH is required. Conversely, since PH is mostly incurable, the potential role of some of these cancer therapeutic agents in the cure of PH should be recognized. In short, the relationship between cancer, cancer therapy, and PH is an interesting one requiring further attention, education, and research.

Cardiovascular Complications of Cancer Therapy

“…Drug amd toxin-induced PH is classified as Group 1. Cancer can cause PH through obstruction of pulmonary artery from organized fibrotic thrombi due to hypercoagulability, which is classified as Group 4 (36,37). Extrinsic compression of the pulmonary vessels from tumors such as pulmonary angiosarcoma, or direct intravascular extension from large B cell lymphoma can also lead to Group 5 PH (38).…”

Comorbidity in Older Patients Hospitalized with Cancer in Northeast China based on Hospital Discharge Data

“…Many population-based surveys and clinical studies have attempted to explore the prevalence of comorbidities and the impact of comorbidities on health care or survival outcomes, such as identifying the comorbidity patterns of mental diseases [8,9], and assessing the impact of comorbidity on health care or outcomes of chronic diseases in the elderly [10,11]. Researchers have attempted to determine the risk of comorbidities in cancer patients [3,12], focusing on specific disorders related to cancers, such as cardiovascular and cerebrovascular diseases [13,14], hypertension [15,16], other associated complications, and/or specific populations with cancer, such as the elderly [17,18]. The overall pattern of cancer comorbidities has not been established to date because survey data are relatively small in size, usually focus on specific disorders, and sometimes include inadequate information on diagnosis and treatment.…”

Rapid development of pulmonary hypertension during treatment of paediatric cancer

“…Despite the severe initial presentations requiring intensive care admissions, the severe pulmonary hypertension symptoms were remarkably responsive to a combination of halting current chemotherapeutic regimens and initiation of inhaled nitric oxide, sildenafil, and prednisone. Kinase inhibitors, in particular dasatinib, have described side effects of pulmonary complications including rapid onset of pulmonary hypertension with rapid resolution on discontinuation of medications in adults 8 9 However, none of the children in this cohort were exposed to dasatinib or other kinase inhibitors.…”

“…Kinase inhibitors, in particular dasatinib, have described side effects of pulmonary complications including rapid onset of pulmonary hypertension with rapid resolution on discontinuation of medications in adults. 8,9 However, none of the children in this cohort were exposed to dasatinib or other kinase inhibitors. Two of the patients had medical history that may be associated with the development of pulmonary hypertension.…”

“…Previous studies have implicated several chemotherapeutic agents in association with pulmonary hypertension, including alkylating agents, antimetabolites, kinase inhibitors, and cytotoxic antibiotics agents. 7,8 Alkylating agents, in particular cyclophosphamide, have been most often implicated in previous reports and were used in greater than half of the chemotherapy-induced cases of pulmonary hypertension in a report from the French Pulmonary Hypertension Network. 7 Cyclophosphamide and other alkylating agents were part of the treatment protocols for each of the patients reported in this cohort.…”