Controlling symptoms of lung cancer
Lung cancer can cause symptoms like breathlessness, a cough, pain, or conditions such as blocked airways, superior vena cava obstruction (SVCO) or pleural effusion. There are different ways these can be treated.
You may have symptoms of lung cancer, such as breathlessness or a cough. Some people may develop new symptoms during their illness.
You may be referred to a doctor or nurse who is an expert in symptom control. They are sometimes called palliative care specialists.
Breathlessness is a common symptom in people with lung cancer. It can be distressing to deal with. It may take a while for treatments to improve your breathing.
Your doctor or nurse will explain if there are suitable treatments to help treat blocked airways. Or if oxygen therapy would be useful.
There are different drugs that can help ease breathlessness. These include:
- bronchodilator drugs to widen your airways – you have these through an inhaler or a mask called a nebuliser
- steroids to reduce inflammation in your lung
- diuretics to help you pass more urine
- small doses of morphine
- drugs that reduce anxiety.
There are things you can do to help manage breathlessness. It is important to pace yourself. Save your energy for the things you need to do or that are important to you.
You may find these tips helpful:
- Sit by an open window or use a fan to create cool air blowing on or across your face.
- Wear loose-fitting clothes.
- Sit down to do things like washing, dressing or preparing food.
- Make it easier to move around your home. For example, you could put a chair in a hallway so you can rest 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.
We have more information about managing breathlessness.
If you have a cough, there are different treatments that can help. Some types of painkiller tablets, such as codeine or morphine can help suppress a cough. You can also have other drugs as a vapour that you inhale. A saline mixture through a nebuliser may help loosen phlegm.
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. Treating the cancer can often improve pain. Your doctor will prescribe painkillers to take regularly.
You can take most painkillers by mouth, but they can also be given as a patch on the skin or as an injection. There are different types of painkiller and they can be given in different ways.
If the cancer has spread to your bones it may cause different problems, including pain. To reduce the risk of bone problems, your doctor may prescribe a drug called denosumab. You have it as an injection under the skin. Another possible drug your doctor may prescribe is zoledronic acid. It is given as a drip.
You may be given 1 or 2 sessions of radiotherapy to treat bone pain. Sometimes surgery may be used to strengthen a weakened bone.
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 is 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 in the airways, doctors may use the following treatments to relieve symptoms:
Cryosurgery (cryotherapy) uses extreme cold to freeze and destroy cancer cells. It is usually used if the tumour grows into the main lung airways and makes them narrow. This is not common, but if it happens you may become breathless. The doctor uses a thin, flexible tube with a rounded end called a probe facing towards the tumour. They use liquid nitrogen to freeze the end of the probe. This freezes and destroys the cancer cells. The liquid nitrogen reduces the size of the tumour in the airway and makes breathing easier. You can have this treatment again if the tumour grows back.
Diathermy or electrocautery
These treatments use an electrical current to destroy cancer cells. You might need a general anaesthetic for this treatment. Your doctor uses a bronchoscope to guide a wire to probe into your windpipe. They pass an electrical current through the probe into the tumour to remove pieces of the tumour. This will make your breathing easier.
Doctors can use laser therapy to shrink the cancer and prevent it from blocking the airways. You usually have laser therapy under a general anaesthetic. The doctor uses a flexible tube (bronchoscope) to aim the laser beam at the tumour. The laser beam uses heat to destroy as much of the tumour as possible.
Another laser treatment called photodynamic therapy (PDT) is sometimes used to treat blocked airways.
Stents to open the airway
If the cancer presses on the airway, the airway can become narrow. A small tube called a stent can be used to open the airway to help you breathe more easily. You may need a general anaesthetic to have a stent put in.
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, the stent opens up like an umbrella. This pushes the walls of the narrowed airway open and makes your breathing easier. It can stay in your lung permanently.
Sometimes more than one treatment can be used, and treatments may be repeated.
You usually have them under a general anaesthetic using a bronchoscopy. The choice of treatment will depend on the size of the tumour and where it is in the airway. The doctor will explain the possible advantages and risks of these treatments to you.
Below is a sample of the sources used in our lung cancer information. If you would like more information about the sources we use, please contact us at firstname.lastname@example.org
National Institute for Health and Care Excellence (NICE). Lung cancer – Diagnosis and management. Clinical guideline 2019.
Metastatic non-small cell lung cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. 2018.
European Society for Medical Oncology (ESMO). Early and locally advanced non-small-cell lung cancer (NSCLC): ESMO clinical practice guidelines for diagnosis, treatment and follow-up. 2017.
This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Senior Medical Editor, Dr David Gilligan, Consultant Clinical Oncologist.
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