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Your kidneys, liver, heart and lungs and cancer medicines
Some cancer medicines can change the way your kidneys, liver, heart or lungs work. But your doctor or specialist nurse will do regular checks to check how well they work.

About kidneys, liver, heart and lungs and cancer medicines
Doctors use many types of medicines to treat cancer. Some medicines can cause changes in the way your kidneys, liver, heart or lungs work.

These changes are usually temporary and stop when your treatment ends. But some medicines can cause permanent changes.

Some chemotherapy medicines, targeted cancer medicines and immunotherapy are most likely to cause these changes. Some hormonal therapies and bisphosphonates cause mild changes. These usually go away after treatment ends.

Even though a medicine can cause these effects, it may not affect you in that way. Medicines affect people in different ways. It's not possible to tell in advance who will have side effects. It depends on:

The medicine or combination of medicines you're taking
The dose
How you react to the medicine
How you've responded to drug treatment in the past
You can't take some cancer medicines with certain medicines for heart, kidney and lung problems. Before you start cancer treatment, your doctor or specialist nurse will Check that you don't have any other illnesses. They'll also want to know if you're taking any other medicines or herbal remedies.

Find out more about cancer medicines
Your kidneys
Some cancer medicines can change the way your kidneys work. The medicines most likely to cause these changes are:

some chemotherapy drugs, such as cisplatin and ifosfamide
Targeted cancer drugs
Immunotherapy
Bisphosphonates
The effect is usually mild, but it can vary between different types of treatment. Other factors may also play a role. For example, how much ifosfamide will affect your kidneys depends on:

The total amount of the medicine you have taken over time (cumulative dose)
Whether you had kidney problems before starting treatment
Whether you are getting them from a medicine called cisplatin
If you are taking medicines that can affect your kidneys, you will need to have a blood test before every treatment. This test shows how well your kidneys are working.

Your doctor may prescribe medicines to protect your kidneys from treatment. Sometimes they adjust the dose of the medicine you are taking.

You may be given extra fluids through a drip for several hours before and after treatment. Your nurse may also ask you to drink lots of fluids and keep a record of how much you drink.

You will need to measure the amount of urine you excrete and keep a record of it. Your nurse may also ask you to weigh yourself before and after treatment. This is to make sure you are not retaining fluid.

Tell your nurse or doctor if you cannot drink as much water as you have been told to, for example, if you feel sick. Also, tell them if you are passing less urine.

Your liver
Some cancer medicines can change the way your liver works. These changes are most likely to happen in people with:

Chemotherapy medicines
Targeted cancer medicines
Immune therapy
Hormone therapy
The effects are usually mild and your liver recovers when treatment is over. Combinations of medicines may have a greater effect on your liver.

When you're taking medicines that can affect your liver, you'll need to have a blood test before each treatment. The test shows how well your liver is working. If it's affecting your liver, your doctor or specialist nurse may change the dose of your treatment. Or they may give you a different treatment.

Your heart

Some cancer medicines can change the way your heart works. The medicines most likely to cause these changes are:

Chemotherapy medicines
Targeted cancer medicines
Immunotherapy
Hormone therapy
The effects of these medicines can be temporary but can sometimes be permanent.

A group of chemotherapy medicines called anthracyclines are more likely to affect the heart. These include the medicines doxorubicin, for example. Anthracycline medicines may affect you more if you:

Have been treated with anthracycline medicines before (cumulative dose)
Are obese
Are over 65 years old
Have a history of heart problems
Have high blood pressure
Smoke
Have high cholesterol
Have diabetes
Some cancer treatments can be combined, such as chemotherapy with targeted cancer drugs. Combining medicines can also affect your heart more.

Your doctor or specialist nurse will check your heart regularly. They will make sure all treatments are as safe as possible. They will adjust your treatment if necessary. You may need to have some tests to see how well your heart is working. These may be:

Electrocardiogram (ECG)
Echo

Cardiogram
Multi-gated acquisition (MUGA) scan
Your lungs
Some cancer medicines can change the way your lungs work. Some cancer medicines that can cause these changes are:

Chemotherapy medicines
Targeted cancer medicines
Immunotherapy
It's not always clear how some cancer medicines affect the lungs. Some medicines cause inflammation of the lung tissue. This is also called pneumonitis.

Sometimes the lung tissue can become thicker and less flexible and it may be difficult for you to breathe. This is called pulmonary fibrosis. This can happen slowly over months or years. You may have a cough or feel short of breath or tired.

Some cancer medicines can cause you to become breathless when exercising or when walking uphill or up stairs.

Your doctor or specialist nurse will check your lungs to find out if the medicines you're taking could be causing lung problems. They'll do this during your treatment and after it too.

In some cases, if you're having serious lung problems because of a cancer drug, your doctor or specialist nurse may have to stop your treatment. To relieve symptoms, they may give you a combination of treatments: