Lung Cancer

Managing Symptoms

Managing the symptoms related to lung cancer is an important component of care. This care is often referred to as supportive or palliative care. Treatment is also available to control the side effects of cancer treatment; treatment-related side effects are discussed in the Side Effects section. The two most common symptoms related to lung cancer are pain and dyspnea (shortness of breath).

Pain

Pain is the leading fear for all people with cancer, yet there are many unfounded fears related to pain medication and pain that prevent people from having their pain managed properly (Table 1). Don’t hesitate to talk to your doctor or other member of your treatment team about your pain or your fears of pain medication. Many treatments are available to control pain, and no one should have to endure pain related to lung cancer.

Mild pain can often be managed with over-the-counter pain relievers, and more severe pain can be controlled with prescription drugs, such as opioids (narcotics). It is important to take pain-relieving drugs exactly as your doctor has ordered. Pain medication should be taken at the intervals suggested by your doctor rather than on an “as needed” basis. Pain medication is more effective when taken this way because it can help stop pain before it develops or worsens.

If your pain is caused by a tumor pressing on a nerve, your doctor may be able to inject medication around the nerve to help relieve pain. This is known as a nerve block. Surgery may also be done to cut nerves that send pain signals to your brain.

Sometimes, radiation therapy or chemotherapy can be given to shrink a tumor that is causing pain or surgery can be done to remove such a tumor. Radiation therapy may also be done to relieve pain caused by bone metastases. You can help manage pain by using some strategies that research has shown to be helpful. These strategies include relaxation therapy, imagery, biofeedback, physical therapy and counseling, to name a few. Be sure to talk to your doctor about how to control your pain so that pain does not control your life.

Table 1. Confronting the Fears of Pain Medication and Pain

Dyspnea (Shortness of Breath)

You may feel short of breath or have difficulty breathing if an airway is blocked by a lung tumor that was not surgically removed or that has recurred. Radiation therapy can be used to shrink a tumor enough to allow for better flow of air. Other procedures are also available to remove a tumor that blocks airways.

Advanced cancer may cause fluid to collect in and around the lungs, which can also make it hard to breathe. A procedure can be done to drain this fluid. Your doctor can also prescribe medications to open closed airways, suppress a cough, or reduce secretions in the bronchi. You may also benefit from inhaling oxygen from a small, portable tank that you can use at home and take with you when you go out.

Be sure to tell your doctor or another member of your health care team if you have shortness of breath so that you can receive the treatment you need to make it easier to breathe.

Additional Sources of Information

• American Academy of Pain Management: www.aapainmanage.org/info/patients.php
• American Society of Clinical Oncology’s patient website: www.cancer.net
    Pain — ASCO Curriculum
• National Cancer Institute: www.cancer.gov
    Coping with Cancer: Supportive and Palliative Care (Managing Physical Effects)
    Pain Control: Support for People with Cancer