Lung Cancer

Shortness of Breath (Dyspnea)

Dyspnea is a medical term that means difficulty breathing, and it’s a common symptom among lung cancer patients. Nearly 90 percent of people with lung cancer experience dyspnea at some point during their cancer journey.

Lung cancer patients often describe dyspnea as a feeling of breathlessness or being short of breath. They feel like they’re not getting enough air, and in extreme cases, like they’re being suffocated or smothered. This can sometimes lead to anxiety and panic, which can worsen dyspnea and start a cycle difficult to stop.

If left untreated, dyspnea can become serious and even life-threatening, so be sure to keep an open dialogue with your doctor about this condition.

Causes of dyspnea

Primary lung cancer can cause dyspnea, as can other types of cancer that have metastasized (spread) to the lungs, certain cancer treatments and conditions unrelated to cancer. Some of the most common causes of dyspnea in people with lung cancer include:

  • Airway obstruction: The tumor is blocking the airways in the chest or lung(s).
  • Blood vessel obstruction: Blood clots and/or tumor cells are blocking a blood vessel in the lung(s).
  • Pleural effusion: The tumor is causing excess fluid to accumulate around the lungs.
  • Carcinomatous lymphangitis: The tumor has spread through the lymphatics of the lung(s).
  • Diaphragmatic paralysis: The tumor has spread and blocked a nerve, causing paralysis of all or part of the diaphragm.
  • Chronic obstructive pulmonary disease (COPD): This group of lung diseases often accompanies lung cancer and may block airflow.
  • Emphysema: One of several diseases of COPD, emphysema damages the air sacs of the lungs.

Some of the most common causes of dyspnea related to lung cancer treatments include:

  • Radiation pneumonitis: Lung damage has been caused by radiation therapy.
  • Weakened heart muscle: The heart has become weak from chemotherapy.
  • Chest infection: An infection, such as pneumonia, has developed because cancer treatments have increased the patient’s risk for chest infections.

Symptoms of dyspnea

The most common symptoms of dyspnea include breathing discomfort, an inability to take in enough air, shortness of breath and a feeling of being suffocated, drowned or smothered. Dyspnea can be a serious condition, so it’s important to talk to your doctor immediately if you experience any of these symptoms.

Diagnosing dyspnea

If your doctor suspects dyspnea, he or she will likely perform a physical examination and a functional assessment as well as one or more of the following tests:

  • Chest X-ray: A chest X-ray is a picture of the inside of your chest.
  • Computerized tomography (CT) scan: A CT scan uses X-rays to create a three-dimensional picture of the inside of your chest.
  • Complete blood count: This blood test measures a variety of things, including the number of red blood cells, white blood cells and platelets; the amount of hemoglobin in the red blood cells; and the percentage of blood made of red blood cells.
  • Oxygen saturation test: This procedure tests how much oxygen the red blood cells are carrying.
  • Maximum inspiratory pressure (MIP) test: For an MIP test, you breathe through a device to measure your lung pressure.

Treating dyspnea

Dyspnea treatment largely depends on what is causing the condition. If a tumor is causing the dyspnea, your doctor may recommend radiation therapy, chemotherapy, hormone therapy, laser therapy or cauterization (burning) to shrink or destroy the tumor. If a blocked airway is causing the dyspnea, your doctor may choose to place a stent in the airway to help hold it open. And if anemia is causing the dyspnea, your best course of treatment may be a blood transfusion.

Sometimes, dyspnea can be caused by excess fluid. In these cases, procedures to drain the fluid surrounding the lungs (pleural effusion), heart (pericardial effusion) or abdominal cavity (ascites) are likely the best treatment choice. Certain medications, including antibiotics, steroids, bronchodilators, anticoagulants and diuretics, may also help you effectively manage the symptoms of dyspnea. Talk to your doctor about which treatment option(s) may be right for you.

Managing dyspnea

Aside from the medical treatments listed above, various techniques and exercises can help you breathe easier on a daily basis. These include:

  • Receiving extra oxygen from a tank or other device
  • Taking opioid medications to encourage relaxation and reduce anxiety
  • Performing breathing techniques to help you take in more air
  • Quitting smoking and/or avoiding smoky places
  • Opening windows or turning on fans to increase air circulation
  • Using a humidifier or vaporizer to moisten the air
  • Drinking a lot of water to help thin mucus and make coughing easier
  • Performing light exercises to increase the flow of oxygen to your blood
  • Sleeping with your head propped up on pillows
  • Practicing relaxation training or meditation to encourage relaxation and reduce anxiety

Each of these options may help you maximize the delivery of oxygen to your lungs. Talk to your doctor before trying something new.


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