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Coping With Shortness of Breath During Cancer

Voiceover: Shortness of breath, also called dyspnea, can be common for people with cancer. This side effect can range from mild to severe, and may include uncomfortable breathing, the feeling of not being able to get enough air, or the sensation of smothering, tightness, or suffocation. Shortness of breath can have many different causes, and may be related to the cancer itself, side effects from cancer treatment, underlying medical conditions, or anxiety or stress.

Causes of Shortness of Breath

• Cancer Itself

• Side Effects of Cancer Treatment

• Underlying Medical Conditions

• Anxiety or Stress

Charu Aggarwal, MD, MPH; Medical Oncologist; Member, American Society of Clinical Oncology: In patients with cancer, shortness of breath could be due to a multitude of factors. I often think of these as factors that are related to either an obstructive cause, such as perhaps a tumor pressing on an airway, impeding air flow, or a space occupying lesion preventing exchange of oxygen, again leading to shortness of breath. But also there can be other causes that that can be related to either therapy or to the disease itself. For example, low blood counts, without having any kind of structural problems within the lung can lead to shortness of breath. In the same vein, inflammation of the lungs, either associated with treatment as we see with some novel immunotherapies or with targeted agents, can also lead to shortness of breath. So there can be a variety of reasons and it's very important for patients to bring this up to their physicians.

Voiceover: Shortness of breath can have a significant impact on quality of life for people with cancer.

Dr. Aggarwal: It can affect simple tasks such as activities of daily living like showering, bathing, even walking to the bathroom sometimes. If patients have shortness of breath, that can really put a strain on performing easy tasks that we take for granted on an everyday basis, but also I think enjoying activities outside of the house. If somebody has a shortness of breath that comes up with exertion, I think that can be very challenging, and limit people from enjoying their full quality of life.

Voiceover: Once the cause of your shortness of breath is determined, your healthcare team will work with you to help manage the symptoms.

Dr. Aggarwal: The ways to manage and cope obviously depend on the underlying cause, however I have found in my patients let's say, who have been post-surgery who have shortness of breath, simple measures such as using an incentive spirometer at home can help with increasing lung volumes and increasing lung capacity. This is a device that expands the lung by helping to take deep breaths as well as take full breaths. There is usually a mouthpiece associated with a ball that provides positive reinforcement, and can be used very intuitively and simply at home. We often use home oxygen and portable home oxygen to help and assist with symptoms of either air hunger or dyspnea which is basically shortness of breath on exertion. And I often talk to patients about also using mindfulness exercises as well, meditative and breathing exercises that may help in situations of anxiety. In addition your doctor may also recommend certain medications for the management of shortness of breath, again depending on the underlying cause. For constriction of the airways, that may sometimes occur, especially in our patients that have underlying emphysema, often we will use inhalers that will help relax the airways. In other situations where shortness of breath is arising due to either underlying inflammation or infection, we may use steroids and/or antibiotics to help ease inflammation as well as treat shortness of breath.

Voiceover: It is always important to tell your doctor if you are experiencing any shortness of breath. If you are noticing sudden shortness of breath, chest pain, or a rapid heartbeat. These symptoms could be signs of a more serious problem and you should seek medical attention right away.

Dr. Aggarwal: I always tell my patients that if you experience any of these symptoms, either with presence of swelling in the calf or without, as that may be an indication for a clot in the leg that may travel to the lung, I always tell them that even if you don't have swelling in your legs, you must call me right away so that we can begin therapy, which may involve the use of blood thinners.

Voiceover: For more information on shortness of breath, please visit Cancer.Net.

Dr. Aggarwal: Cancer.Net represents a really valuable resource for patients, caregivers, advocates, as well as healthcare providers, to look for resources on what to do, to learn about shortness of breath, to learn about management of symptoms, as well as how to take the next step.

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