While it’s hard to know exactly how prevalent it is, research suggests that up to 60 percent of patients with advanced lung cancer experience dyspnea. A person with dyspnea might be able to breathe normally while sitting or standing, “but [if] they take some steps, go up a flight of stairs, or walk around the mall, [they] feel short of breath,” says Jonathan Riess, MD, an oncologist and a lung cancer specialist at UC Davis Comprehensive Cancer Center in Sacramento, California. RELATED: 8 Ways to Practice Self-Care During Metastatic Non-Small-Cell Lung Cancer Treatment
Why Do People With Lung Cancer Get Dyspnea?
There are a number of causes of shortness of breath in people with NSCLC. “Finding the cause is critical to treating the symptoms,” Dr. Riess says, adding that potential sources of the problem include the following:
Growth of the cancerBlood clotsInfectionFluid buildup in or outside the lungsExacerbation of chronic obstructive pulmonary disease (COPD)Adverse reactions to cancer treatmentsLow levels of oxygen in the bloodAnxiety
Quit smoking. If you’re still smoking, it’s important to stop. According to the American Lung Association, smoking tobacco can cause or aggravate shortness of breath in a number of ways — from raising your risk of lung and airway infections to directly limiting the ability of your lungs to take in oxygen. A study published in 2016 in the New England Journal of Medicine found that about 50 percent of current or former smokers had respiratory symptoms such as dyspnea, even if they had preserved pulmonary function of their lungs. Move, and take deep breaths. If the alveoli — the tiny air sacs in your lungs where carbon dioxide and oxygen are exchanged between the lungs and the bloodstream — aren’t regularly expanded and filled up with air, they can collapse slightly, leading to an increased risk of infection, says Riess. “Taking deep breaths and walking around as much as possible helps keep the lungs open,” he says. Exercise. Gentle exercise can help strengthen the muscles you use during respiration. A few studies have shown that participating in a pulmonary rehabilitation program may decrease symptoms of dyspnea and boost exercise tolerance. These programs typically involve 6 to 12 weeks of aerobic exercise and resistance training along with education and behavior-modification instruction. Prevent infections. A lung infection — like pneumonia — is a common reason for breathing problems among people with NSCLC, says Riess. You can reduce your risk of future infections by getting a seasonal flu shot, making sure you are up-to-date with your pneumonia shot, and washing your hands frequently. Be aware of adverse reactions. Some cancer treatments can lead to an inflammation of the lungs known as pneumonitis. “It’s kind of an allergic reaction,” Riess explains. Similarly, fluid may accumulate in your lungs because of infection, cancer, or cancer treatments. “Finding out what is causing the fluid buildup is essential to properly treating it,” says Riess. Ask if you need a bronchodilator. If you have COPD, NSCLC and its treatment, as well as any lung infections, can aggravate your wheezing and other breathing difficulties. In such cases, Riess says it’s important for people to treat their symptoms with an effective bronchodilator. Sometimes steroids are also necessary to reduce inflammation in the airways. Talk to your doctor about treatment options if you have COPD. Manage anxiety. Some studies show that nearly half of patients with advanced lung cancer experience anxiety. And anxiety can play a role in shortness of breath, Riess says. “It can be very stressful to be going through cancer treatment and everything associated with it. Treating anxiety can involve nondrug approaches like relaxation techniques and psychotherapy, as well as medications for both long-term treatment and the management of acute symptoms. Consider palliative care. Palliative care is designed to improve comfort. Options for shortness of breath may include opioid drugs like morphine, which can reduce the sensation of not being able to breathe adequately. Ask your doctor if there’s a palliative care program where you’re being treated, or if they can refer you to one. RELATED: How Exercise ‘Prehab’ and Rehab Can Change the Game for Lung Cancer Patients Additional reporting by Julie Marks.
