Dyspnea is a feeling of breathlessness. Many people with advanced cancer may experience it. People with earlier-stage cancers who have other conditions that affect the heart or lungs, such as a blood clot, may also have dyspnea.
Common symptoms of dyspnea include:
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Uncomfortable breathing
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Shortness of breath
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Not being able to get enough air
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A feeling of smothering, tightness, drowning, or suffocation
Finding the cause of shortness of breath
A person may have dyspnea even though the actual levels of oxygen are within a normal range. It is important to understand that people do not suffocate or die from dyspnea. But tell your health care team right away if you have any of these symptoms or if they get worse. Relieving side effects is an important part of cancer care and treatment. This is called palliative care or supportive care.
To learn more about your symptoms, your health care team will:
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Review your medical history
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Ask you to describe your symptoms and what makes them worse
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Ask you to rate your symptoms on a scale
Causes of shortness of breath
Dyspnea may be caused by a tumor or another condition related to cancer. But many of these causes can be treated. Some common causes of dyspnea include:
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Blocked airway, such as by a tumor
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Narrowing of the airway, called a bronchospasm
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Shortage of oxygen in the blood, called hypoxemia
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Pneumonia or infection
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Inflammation of lungs after radiation therapy, called radiation pneumonitis
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Low red blood cell count, called anemia
Shortness of breath in people with advanced cancer (updated 02/2021)
For people with advanced cancer, identifying and managing shortness of breath is an important part of care. At each of your appointments, your health care provider will evaluate you for shortness of breath by asking you questions and looking for symptoms. If you are experiencing shortness of breath, your health care provider will also want to evaluate the symptom’s severity. They will ask you questions to find out how long it has lasted, what is causing it, what triggers it, and ask about any other symptoms that may be associated with it. They will also see whether shortness of breath is affecting your day-to-day activities and emotions. All people with advanced cancer who have shortness of breath should be referred to a palliative care team.
If you have a common cause of dyspnea (see “Causes of shortness of breath,” above), your health care provider will talk with you about treatment options based on your preferences and overall health. If the cancer itself is causing your shortness of breath, further treatment to remove or reduce cancer may be recommended as part of your overall care plan.
Your provider may also recommend strategies to help with improving airflow, such as directing a fan at your cheek or sitting in front of a fan. If the levels of oxygen in your blood are low, you may need supplemental oxygen. A low level of oxygen in the blood is called hypoxemia. Practicing breathing techniques like pursed lip breathing and belly breathing, also called diaphragmatic breathing, may help relieve shortness of breath. Certain body positions can also provide relief. It is important to have a plan to manage episodes when you experience shortness of breath.
Your health care provider might recommend complementary therapies to manage dyspnea without medication, such as:
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Breathing techniques
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Relaxation techniques
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Distraction strategies
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Posture techniques
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Physical therapy
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Acupressure, which is when physical pressure is applied to acupuncture points
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Reflexology, which applies pressure to the feet, hands, and ears
Sometimes, relieving shortness of breath without the use of medication may not work. There are different ways to treat shortness of breath with medication, including:
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Pain medications called opioids to relieve shortness of breath
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Short-acting benzodiazepines, a type of anxiety medication, to relieve anxiety caused by shortness of breath
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Anti-inflammatory drugs called corticosteroids to treat lung inflammation or airway obstructions
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Bronchodilators, also known as inhalers, can be used to relieve symptoms for certain patients
This information is based on the ASCO guideline, “Management of Dyspnea in Advanced Cancer.” Please note that this link takes you to another ASCO website.
Related Resources
When to Call the Doctor During Cancer Treatment