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Managing lung cancer symptoms

Lung cancer symptoms can have a significant impact on your quality of life. However, there are exercises and techniques to help you manage lung cancer symptoms.

Managing lung cancer symptoms can significantly improve your quality of life
Managing lung cancer symptoms can significantly improve your quality of life

There are many different lung cancer symptoms. Some symptoms can appear before you are diagnosed, whilst some may develop post-diagnosis or during treatment.

Lung cancer affects people in different ways. You may have general symptoms of not feeling well, or you may have specific symptoms related to your lungs or to other parts of your body affected by the cancer.

Common symptoms for people living with lung cancer include:

  • Breathlessness
  • Tiredness (fatigue)
  • Coughing
  • Pain management
  • Constipation
  • Weight loss or loss of appetite.

In this section, we will share exercises which may help relieve your symptoms and improve your quality of life.

Whilst breathing is something we do all the time and seems automatic, with practice you can learn to increase your control over it.

Breathing techniques

Purse-lip breathing

  • Inhale through your nose for several seconds with your mouth closed.
  • Exhale slowly through pursed lips (like you’re going to whistle) for 4-6 seconds.

Diaphragmatic breathing

  • Relax your chest and shoulders.
  • Place your fingers lightly at the front of your chest on your stomach.
  • Give a little cough. The muscle you feel under your fingers is your diaphragm.
  • Breathe in and feel the expansion of the lower ribs and stomach rise under your fingers.
  • Breathe out as gently as possible like a sigh, feeling the lower ribs come down and in.
  • Try to repeat this exercise about five or six times.
Diaphragmatic breathing

Expansion of your lower chest

  • Place your hands on either side of your chest.
  • Breathe out through your mouth, letting your ribs sink in as far as possible.
  • Then, breathing in through your nose or mouth, feel your ribs expand outwards towards your hands.
  • Gently breathe out to start again.
  • Try to repeat the exercise about five or six times.

Changing positions

There are several positions that can also help when you are short of breath:

  • Sitting leaning forward
  • Sitting upright
  • High side lying (lie on your side with your head, neck and side propped up with pillows)
  • Standing leaning forward
  • Standing leaning back or sideways.

The most important thing is to be comfortable. Choose a position that will suit what you are doing and where you are. Your physiotherapist can help you if you are unsure.

Learning to relax and letting go of muscle tension, such as hunched shoulders, clenched fists or feeling a knot in your stomach, can also be a useful method of controlling anxiety and breathlessness.

Many Cancer Centres offer relaxation sessions to help you learn techniques. Our Living with lung cancer booklet also has more information about relaxation.

Top tips for breathlessness

  • Using an electric or handheld fan can help to reduce feelings of breathlessness.
  • Avoid having too hot showers or bath as steam can affect your breathing.
  • Take your time. Rushing will only shorten your breath more.
  • Keep rooms well ventilated.
  • Avoid too much bending and stretching by keeping items you use frequently within easy reach.
  • If you are a smoker, stopping smoking will improve your breathlessness.
  • Swap heavy shopper bags for a shopping trolley or rucksack.
  • Try to do light exercise such as swimming, walking, yoga and Pilates.

Getting out, exercising and breathlessness

Breathlessness can affect everyday activities and make getting out and about difficult. Try and plan ahead if you are going out. If you are going somewhere unfamiliar, try to get information in advance, for example, make sure that lifts and parking/transport facilities are nearby.

You may find that in certain atmospheres your mouth becomes dry or that you cough more. You may find that cold/damp weather or forced air/humid environments such as shopping centres can make you feel more breathless. It can be helpful to have a small bottle of water or some sweets handy.

Understandably, people who experience breathlessness may be nervous about being too active. However, light exercise can have real benefits to your wellbeing. Certain exercises that focus on breathing can prove helpful, for example, swimming, walking, yoga and Pilates.

Light exercise, like aerobics, can help reduce breathlessness
Light exercise, like aerobics, can help reduce breathlessness

I discovered freestyle aerobics to be the best way to improve my breathing. I started slowly with minimum reps and gradually built myself up.

Roberta, living with lung cancer

If you are having difficulty breathing whilst performing day-to-day activities, such as walking, bathing or dressing, then you may qualify for some financial benefit from the government. You may also be entitled to a disabled badge for parking the car or travelling expenses.

People with lung cancer often feel very tired and have a lack of energy. Fatigue can be caused by the cancer itself, side effects of treatment, anaemia, side effects of other drugs, such as steroids or painkillers, or anxiety/depression.

Fatigue can cause a feeling of having no energy and no strength to do anything – even getting out of bed can be a challenge. Fatigue can affect the way you think and feel so it is important to try and manage your tiredness as much as you can.

Top tips for managing fatigue

  • Use a stool to sit on when gardening.
  • Check your bed/chairs are high enough for you to get on/off easily.
  • A high toilet seat can be ordered if your toilet is too low.
  • A grab-rail beside the bath, shower or toilet will help you steady yourself.
  • Get someone to help you to prepare your food for the day. It may also be useful to make several portions of meals and freeze them for use on days when you don’t feel able to cook.
Sitting on a stool when you are gardening can help reduce fatigue

It is also important to get a good night’s sleep. If you are having difficulty sleeping, here are a few simple changes that might help:

  • Avoid caffeine in drinks (coffee, tea, fizzy drinks) before bedtime.
  • Try herbal/camomile tea.
  • Drinking alcohol in the evening may prevent you having a restful night’s sleep.
  • Try to relax before going to bed – have a bath (not too hot), read or listen to music.
  • Relaxation techniques may also help you at bedtime.
  • Make sure the bedroom is not too hot or cold.

Coughing is a common and distressing symptom for lung cancer patients and can affect many areas of your life.

Top tips for managing your cough

  • Try to increase your oral intake of fluid, preferably with water. You should drink around 6 – 8 glasses of water a day.
  • Drinking warm honey and water and sucking on sweets or lozenges will also help.
  • Try breathing in steam from hot water – add some herbal drops to the water.
  • A cough linctus or cough suppressant can be prescribed by your GP.
  • If you are coughing up phlegm, sitting in an upright position will help you cough better.
Drinking water can help minimise your cough

If you are coughing up phlegm (sputum), it should be clear or white in colour. If it becomes discoloured e.g. yellow, green or bloody, please inform your healthcare team.

Some patients with lung cancer will cough up blood. This is called haemoptysis (he-mop-ti-sis) and can be very distressing. It can be caused by a bleed in the blood vessels in the lung, an infection or clot in the lung.

It is important to tell your cancer doctor or lung cancer nurse specialist about this and further investigations or treatment can be given.

Not everyone but some people will experience pain with lung cancer. Some people experience pain after treatments for lung cancer and understandably worry that it is a sign that the cancer has come back or has spread. This is not necessarily the case as many people experience pain not caused by cancer.

Top tips for managing pain

  • Keeping a diary may help you to know when you have pain. Show this to your cancer doctor or lung cancer nurse specialist so they can help you to manage your pain.
  • For mild pain, you may be prescribed a mild painkiller (called an analgesic) like paracetamol or a non-steroidal anti-inflammatory drug like aspirin, ibuprofen or diclofenac sodium.
  • For moderate pain, you may be prescribed a weak opioid drug like codeine or tramadol.
  • For severe pain, you may be prescribed a strong opioid painkiller like morphine, oxycodone, fentanyl or diamorphine.
  • Other treatments to help manage pain can include chemotherapy, radiotherapy or complimentary therapies such as acupuncture and relaxation techniques.

Constipation affects many people who have cancer, or who are having treatment for cancer. Symptoms can include:

  • Having less frequent bowel movements.
  • Straining when passing stools (faeces).
  • Your stools (faeces) becoming harder.
  • Feeling bloated and experiencing wind.
  • Pain in your stomach or back passage.

If you have not had a bowel movement for three days, you should speak to your GP, cancer doctor or lung cancer nurse specialist. They may prescribe laxatives to help relieve your constipation.

Top tips for managing constipation

  • Have plenty of fibre in your diet. Foods rich in fibre include fresh fruit and vegetables, brown rice, wholegrain cereals, kidney beans, lentils and chickpeas.
  • When eating bread choose wholemeal, wholegrain, granary or multi-seed bread.
  • Drink plenty of fluids. Try to drink at least 6-8 glasses per day.
  • Try to limit the amount of caffeine, alcohol and fizzy drinks you consume.
  • Don’t ignore the urge to go to the toilet. When you do go, some people find that leaning forward and relaxing will help them open their bowels more easily.
  • Exercise can affect your bowel habits. Try gradually increasing the amount of exercise you do. Walking, swimming and cycling each day will help to keep your bowels moving.
Eating fresh fruit and vegetables can help ease constipation
Eating fresh fruit and vegetables can help ease constipation

It is common for people with lung cancer to lose weight. There are many reasons for this; you may be eating less than you normally do or your body may not be absorbing enough of the food you eat. Other symptoms such as breathlessness, pain and constipation can all affect your appetite.

Top tips for managing weight loss and/or loss of appetite

  • Try eating small frequent meals rather than three large meals a day.
  • Eat meals that are small in portion size but high in calories.
  • Add ingredients such as cream, cheese, full fat milk, butter, yoghurt whenever possible.
  • Keep nutritious snacks handy, eat when you feel able and treat yourself to foods that you particularly enjoy.
  • Try not to drink too much tea, coffee or water as these are low in energy and can fill you up.
  • Try full fat milk, milky coffee or supplement drinks, such as Complan or Build-up.

Your healthcare team will monitor your weight and can refer you to a dietitian for advice on eating a balanced diet. The dietitian can advise which foods would be best for you and suggest foods supplements to help you. Your GP or hospital doctor may also prescribe a short course of steroids to increase your appetite, food intake and feeling of wellbeing.

Managing other lung cancer symptoms

There are other less common symptoms and side effects which people who have lung cancer also experience. These include:

  • Fluid in the lining of the lungs (pleural effusion)
  • Hoarse voice
  • Swallowing difficulties
  • High calcium (called hypercalcaemia)
  • Low sodium (called hyponatraemia)
  • Superior vena cava cord compression (SVCO)
  • Metastatic spinal cord compression (MSCC)
  • Symptoms from secondary cancer of the brain.