Controlling symptoms of lung cancer
You may have symptoms, such as breathlessness, pain or a cough. Some people may develop new symptoms during their illness. Chemotherapy and radiotherapy help, but there are also other ways to manage and control symptoms.
You may be referred to a doctor or nurse who is an expert in symptom control. They are sometimes called palliative care experts.
Some lung cancers make hormones or antibodies that upset the body’s chemical balance. These may cause symptoms such as feeling sick or drowsy. If you have these symptoms or any listed below, tell your doctor or cancer nurse straight away.
There are things you can do to help manage breathlessness. It is important to pace yourself. Save your energy for the things that you need to do or that are important to you.
You may also find the following tips helpful:
- Sit by an open window or use a fan, so you have cool air blowing on or across your face.
- Wear loose-fitting clothes and sit down to do things like washing, dressing or preparing food.
- Make it easier to get around your home. For example, put a chair in a hallway so you can rest when you are going between rooms.
- Ask an occupational therapist about aids that can help, such as grab rails or a raised toilet seat.
- Ask your nurse or physiotherapist about controlled breathing exercises or relaxation exercises to make living things easier.
There are different drugs that can help relieve or manage breathlessness. For example, you may have:
- bronchodilator drugs to widen your airways – you have these through an inhaler or a mask called a nebuliser
- steroid drugs to reduce inflammation in your lung
- drugs called diuretics to help you pass more urine
- small doses of morphine, which helps ease breathlessness
- drugs that help relieve anxiety.
We have more information about managing breathlessness.
If you have a cough, there are different treatments that can help. You may have some types of painkiller tablets. You can have other drugs as a vapour that you inhale. Sometimes a short course of radiotherapy may help improve a cough.
Tell your doctor or nurse if you have pain. There are different ways to control it, and they can explain the best way to manage pain in your situation. There are different types of painkiller and they can be given in different ways, such as:
- by mouth
- as a patch on the skin
- as an injection
- as a continuous infusion through a small electrical pump.
If you have cancer that has spread to your bones and it causes you pain, you may be given bone-strengthening drugs called bisphosphonates. You may be given one or two sessions of radiotherapy to treat bone pain.
We have more information about managing pain.
Lung cancer may cause other conditions that cause breathlessness and other symptoms. Cancer treatments can help improve these, but there are other ways they can be treated. Your doctor or nurse will give you more information about these.
Cancer in the lung can cause fluid to build up between the layers that cover the lung (the pleura). This is called a pleural effusion.
To treat a pleural effusion, the fluid has to be slowly drained. We have more information about draining a pleural effusion.
Superior vena cava obstruction (SVCO)
The superior vena cava (SVC) is a big vein in the middle of the chest. It carries blood from the upper body to the heart. If lung cancer presses on the SVC, it may block the flow of blood along this vein. This is called superior vena cava obstruction (SVCO).
Symptoms can develop quickly. They include:
- a feeling of fullness in the face when you bend over
- swelling in the face, neck, arms, hands, and veins in the chest
- feeling dizzy
- changes in your eyesight.
SVCO needs to be treated quickly. The symptoms can be distressing, but they can usually be controlled quickly. We have more information about treating SVCO.
When the cancer is causing a blockage or narrowing the airways, doctors usually use the following treatments to relieve symptoms. You usually have them under a general anaesthetic using a bronchoscopy. Another treatment called photodynamic therapy is occasionally used for people with advanced cancer.
Cryosurgery (cryotherapy) uses extreme cold to freeze and destroy cancer cells. It is usually used if the tumour grows into the main lung airway (trachea) and makes it narrow. This is not common, but if it happens you can become very breathless.
You may have a general anaesthetic for this treatment. The doctor uses a bronchoscope to guide a thin, flexible tube with a rounded end (probe) close to the tumour. They pass liquid nitrogen through the probe into the tumour. This freezes and destroys the cancer cells. You can have this treatment again if the tumour grows back.
Diathermy or electrocautery
These use an electrical current to destroy cancer cells. Sometimes both treatments are given together. You usually have diathermy under a general anaesthetic. Your doctor uses a bronchoscope to guide a probe into your windpipe. They pass an electrical current through the probe into the tumour to destroy the cancer cells.
Doctors can use laser therapy to shrink the cancer and prevent it from blocking the airways. It can help reduce or get rid of breathlessness. You usually have laser therapy under a general anaesthetic.
The doctor passes a flexible tube through a bronchoscope, to aim the laser beam at the tumour. The laser beam uses heat to destroy as much of the tumour as possible.
Usually there are no side effects from laser therapy. You can go home from hospital on the same evening or the next day. Laser treatment can be used more than once.
Stents to open the airway
If the cancer presses on the airway, it can become narrow. A small tube called a stent can be used to open the airway to help you breathe more easily.
You usually have a stent put in under a general anaesthetic. The doctor puts the stent inside the airway using a bronchoscope. The stent is folded flat when it is first inserted. As it comes out of the bronchoscope, it opens up like an umbrella. This pushes the walls of the narrowed airway open. It can stay in your lung permanently.