Managing Breathing Problems in Lung Cancer: Pulmonary Rehabilitation

Lung cancer itself and/or its treatments may reduce lung capacity, meaning difficulty performing respiratory functions. Respiration involves taking in oxygen and removing carbon dioxide. Reduced lung capacity from various causes manifests as shortness of breath. Shortness of breath (dyspnea) is awareness of breathing and difficulty doing so. Its severity indicates how much lung capacity has fallen. For example, breathlessness after walking 10 meters differs from that after climbing 1 flight of stairs. Pulmonary rehabilitation aims to continually move the person to a higher level of lung capacity.

Breathlessness Is an Unpleasant Feeling Nobody Wants to Experience

Reduced lung capacity causes more than breathlessness: patients also face lower exercise capacity, fatigue, restlessness and poorer quality of life. Dysfunction of this vital organ may prevent simple daily tasks. Pulmonary rehabilitation seeks to improve this situation as much as possible, with the following goals;

• Increasing exercise capacity to reduce impairment
• Improving adherence to recommended treatments 
• Reducing symptom severity and frequency
• Improving mood and motivation 
• Reducing dependence in meeting personal needs
• Improving self-management and participation in treatment decisions
• Improving ability and participation in daily activities 
• Improving quality of life
• Reducing healthcare costs
• Improving survival

Pulmonary rehabilitation has also been shown to reduce costs associated with chronic obstructive pulmonary disease (COPD), a major health problem.

What Reduces Lung Capacity in Lung and Other Cancers?

The lung tumor's size and location: It may completely or almost completely block a main bronchus.

Surgical cancer treatment: During lung cancer surgery, a large part of the affected region or an entire right or left lung is generally removed.

Radiotherapy for lung or nearby cancers: Radiation damage may occur depending on dose or lung tissue sensitivity.

However, today;

Existing chronic lung disease may intensify these problems. For example, lung cancer patients with COPD, chronic bronchitis, emphysema or asthma beforehand experience more severe lung-capacity difficulties.

Because smoking commonly causes both cancer and these chronic lung diseases, their coexistence is not unusual.

Concurrent COPD occurs in %73 of men and %53 of women with lung cancer. Other conditions, such as chronic kidney or heart disease, may also accompany lung cancer and increase respiratory burden.

What Does Pulmonary Rehabilitation Include?

Its therapies can be grouped into 

• physical activity,
• patient education and
• behavior change

as 3 categories.

Physical activitylimitations vary by patient but are particularly marked and widespread in advanced disease. Programs address strength, endurance and exercise capacity.

Patient education is vital to pulmonary rehabilitation. It covers coughing techniques, airway-clearing maneuvers and breathing methods such as diaphragmatic breathing.

Behavior changesmust be developed and established; this is the process's most important component for maintaining gains.

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An Individualized Approach

The most important planning element is identifying each patient's rehabilitation needs according to their current condition. As in nearly every medical field, collaboration across disciplines for the patient's best interests is essential. Lung and other cancers may also cause muscle weakness, fatigue, weight loss, depression and sleep disorders . These effects of cancer and treatment can be addressed through various approaches. For exercises improving lung capacity, the patient's nutritional status and physical and psychological condition must be suitable. A palliative care team aiming to address all oncological problems for patients and relatives is therefore essential. Cancer treatment requires palliative care, and palliative care requires pulmonary rehabilitation.

Studies evaluating pulmonary rehabilitation in lung cancer consistently find increased exercise capacity and quality of life and reduced cancer-related symptoms such as breathlessness among patients.

Pulmonary rehabilitation may be home- or hospital-based. Continuing the home component after hospital instruction is very important. Maintaining gains and establishing behavior changes sustain benefits.

This article's main goal is to raise awareness of pulmonary rehabilitation. Having sufficient, reliable information about an approach introduced for one's health is the most important factor improving treatment success and easing the process.