Managing lung cancer symptoms

Tuesday 1 November, 2016

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On this page: Shortness of breath (breathlessness) | Fatigue | Poor appetite and weight loss


For many people, lung cancer is diagnosed at an advanced stage. The main goal of treatment is to manage your symptoms and keep them under control for as long as possible. Treatment can help you feel better and improve quality of life. This is called palliative treatment.

Shortness of breath (breathlessness)

Many people with lung cancer have difficulty breathing (dyspnoea) and shortness of breath. This can be challenging and may cause distress. There are surgical ways to reduce its impact on your life.

Thoracentesis (pleural tap)

For some people, fluid may build up in the space between the two layers of thin tissue covering the lung (pleural cavity). This is called pleural effusion and may make it hard to breath. A procedure called thoracentesis or pleural tap can relieve this symptom.

To drain the fluid, your doctor or radiologist numbs the area with a local anaesthetic and inserts a hollow needle between your ribs into the pleural cavity. This will take about 30–60 minutes. You don’t usually have to stay overnight after a thoracentesis. A sample of the fluid is sent to a laboratory for testing.

Pleurodesis

Pleurodesis means closing the pleural cavity. This may be required if the fluid accumulates again after you have had a thoracentesis. It is usually done with a type of keyhole surgery called video-assisted thoracoscopic surgery (VATS).

During the VATS, a thin instrument with a light is inserted into the pleural cavity and some sterile talcum powder is injected into the space. This causes inflammation that closes the pleural cavity and prevents fluid from building up again. Pleurodesis is usually performed under a general anaesthetic by a thoracic surgeon and requires a hospital stay of two or three days. If you are unable to have a general anaesthetic, this procedure can be performed by a doctor under local anaesthetic.

Indwelling pleural catheter

An indwelling pleural catheter is a small tube used to drain fluid from around the lungs. It may be offered to people who repeatedly experience a build-up of fluid in the pleural cavity that makes it hard to breathe.

The surgeon inserts the catheter through the chest wall into the pleural cavity. One end of the tube remains inside the chest, and a small length remains outside the body for drainage. This end is coiled and tucked under a small dressing. The pleural catheter is connected to a small bottle to remove fluid and help you breathe.

You may have to drain the fluid 1–2 times a week depending on how quickly it builds up again. You can manage the catheter at home with the help of a community nurse. Your family or a friend can also be taught how to clear the drain.

Ask your health care team for assistance obtaining any equipment than may help, such as an oxygen concentrator.

Fatigue

It is common to feel very tired during or after treatment and you may lack the energy to carry out day-to-day activities. Fatigue for people with cancer is different from tiredness, as it doesn’t always go away with rest or sleep.

If fatigue continues for long periods of time, you may lose interest in things that you usually enjoy doing or feel unable to concentrate on one thing for very long. Let your treatment team know if you are struggling with fatigue. Sometimes fatigue can be caused by a low red blood cell count or the side effects of drugs, and can be treated.

Poor appetite and weight loss

For many people, losing weight and interest in eating are common. These symptoms may be caused by nausea, difficulty swallowing, breathlessness, or feeling down.

Maintaining good nutrition will help you cope better with day-to-day living, treatment and side effects, and improve your quality of life. You may find it useful to talk to a dietitian who is experienced in treating people with cancer.


Reviewed by: Dr Dishan Herath, Medical Oncologist, Royal Melbourne Hospital, VIC; Sue Lilley, 13 11 20 Consultant, Cancer Council SA; Nev Middleton, Consumer; A/Prof Matthew Peters, Professor of Respiratory Medicine, Faculty of Medicine and Health Sciences, Macquarie University, and Senior Staff Specialist, Department of Respiratory Medicine, Concord Hospital, NSW; Dr Shawgi Sukumaran, Medical Oncologist, Flinders Medical Centre, SA; and A/Prof Shalini Vinod, Radiation Oncologist, Liverpool Hospital, NSW.

Updated: 01 Nov, 2016