Return to Freeding after Cancer Treatment

I have been a breath-hold diver for the past 14 years. I was diagnosed with stage IIIA non-small-cell lung cancer last April and had three rounds of chemotherapy and 27 rounds of radiation followed by a resection of the superior lobe of my right lung. A year later, I am in remission, and my surgeon stated that I could return to diving with a depth limit of just under 10 feet (3 meters). Is it safe to dive, and should I restrict my freediving to that depth?

Although some divers may continue to actively dive with little or no limitations after recovery from a disease or surgery, lung disorders carry unique risks.

Your surgeon’s depth restriction likely reflects some concern about your lung function and the possibility of air trapping. Shallow water, however, does not always mean it’s safe. Your lungs must tolerate rapid changes of volume with the pressure at shallower depths, and the greatest changes occur in the first 33 feet (10 meters). Remaining in shallow water does not reduce your risk of pulmonary injury.

For scuba diving, two significant factors can limit your breathing capabilities: immersion in water and the increasing density of your breathing gas. Another issue is the impact of any fibrotic or scarred tissue in your lungs. After lung resection, your maximum breathing capacity could be severely reduced, which could impair your ability to tolerate exertions underwater. The surgery may have reduced your lungs’ elasticity or function. Any areas of air trapping may be prone to rupture with minimal overinflation.

When planning a return to diving, you should consider your medical condition, any medications you take and the impact of diving on your body. Physical issues may reduce your exercise tolerance, and physiological processes such as lowered immunity and impaired blood clotting could be detrimental and possibly life-threatening. Chemotherapy can damage your immune system, skin (your body’s barrier), heart, lungs and other organs. Diving may expose you to an environment that you may not be able to tolerate in a weakened state.

We recommend that you receive an assessment of your exercise capacity for compatibility with diving. Your physician will check your lung structure and function, which may include a pulmonary function test (PFT) and cardiopulmonary exercise test (CPX). If your doctor clears you for diving, you should keep medical history records with you every time you dive in case of an emergency.
— Shannon Sunset, CPT, NREMT- VFF

© Alert Diver — Q2 2021