Shortness of breath, also known as dyspnea, is common in people with lung cancer. It can feel like your breathing is shallow or rapid, or it may feel harder to pull air into your lungs. It can feel uncomfortable, but this can happen even when oxygen levels in the blood are normal. Some causes of shortness of breath may be related to cancer and others are not.

It is important to call your healthcare team if you have any concerns about your breathing. They can determine the cause of your shortness of breath and offer help to improve your airflow, including medicine, medical devices, or lifestyle changes.

Shortness of breath can be caused by lung cancer, its treatments, or other health conditions. Knowing the root cause is important because it allows your healthcare team to find the correct way to treat it.

Sometimes, lung cancer itself can cause shortness of breath due to:

• Buildup of fluid around the lungs, known as pleural effusion
• Buildup of fluid around the heart, known as pericardial effusion
• Growth of tumors into airways
• Blood clots that travel from the legs to the lungs

Shortness of breath caused by lung cancer treatments can result from:

• Anemia (low red blood cell count)
• Lung irritation after radiation therapy to treat lung cancer, known as radiation pneumonitis
• Immunotherapy pneumonitis, in which the strengthened immune system affects healthy lung cells along with cancer cells
• Surgery that removes part of the lung, making it smaller
• Scarring after lung cancer surgery, which can also reduce lung size

There are other health conditions that can cause shortness of breath that are common in people diagnosed with lung cancer. These can include:

• Pneumonia
• Respiratory tract infections
• Anxiety
• Chronic obstructive pulmonary disease (COPD)
• Asthma
• Congestive heart failure
• Hypothyroidism
• Obesity

Alert your healthcare team if you have been diagnosed with any of the health conditions listed above or have shortness of breath. There are many techniques and medicines that can help, even when several factors are involved.

Once your healthcare team finds the cause of your shortness of breath, they can take steps to resolve it. This may include providing oxygen, medicines, respiratory therapy, or other treatments.

If you have shortness of breath due to worry or stress, your healthcare team may talk to you about anxiety solutions such as medicines, mindfulness, walking, yoga, journaling, visualization exercises, and/or joining a support group.

Your healthcare team may also suggest lifestyle changes.

Practical tips:

• Stay away from heavy pollution and smoky places. If you smoke, try to cut back. Your healthcare team can help.
• Try light exercise, if you can, as exercise may help improve the flow of oxygen to your blood.
• Sleep with your head raised (on pillows) to help you breathe easier.
• Manage anxiety by taking slow, steady, deep breaths and trying to picture a setting that relaxes and calms you.
• Do breathing exercises, like breathing in through your nose for 4 counts, holding your breath for 4 counts, then blowing out slowly through pursed lips for 8 counts.
• Use a handheld fan to activate facial nerves. This can help you feel like you can breathe easier.

It’s always a good idea to tell a member of your healthcare team when you notice a side effect from treatment or a symptom that concerns you. Often, these problems can be prevented or eased with help from your healthcare team or through palliative care services. Shortness of breath is a common side effect that is often easily treated. However, sometimes it can cause more serious issues, and there are times when urgent medical care may be needed.

Contact your healthcare team without delay if you have severe shortness of breath or other symptoms such as:

• Mucus that is excessive or a different color than usual
• Pressure or pain in your chest
• A fever higher than 100.5 degrees Fahrenheit
• Confusion
• Difficulty speaking
• Blue or colorless skin, mouth, or fingernails
• Wheezing
• A fast heart rate or irregular heartbeats
• Lightheadedness
• Flaring nostrils
• An inward pulling on chest muscles while inhaling