Supportive care for lung cancer

Supportive care is about the physical, practical, emotional and spiritual challenges of cancer. This important part of cancer care focuses on improving the quality of life of people with cancer and their loved ones, especially after treatment has ended.

Recovering from cancer and adjusting to life after treatment is different for everyone. It will depend on where the cancer was in your body, the stage of the cancer, the organs and tissues removed during surgery, the type of treatment and side effects and many other factors.

If you have been treated for lung cancer, you may have the following concerns.

A cough is one of the most common concerns for people with lung cancer during all stages of the disease. Tell your healthcare team if you have a new cough, or if there are any changes to a cough you've had for a while. Coughing can stop you from sleeping well and make you very tired. It can even cause you to throw up or fracture a rib if you cough hard enough.

The cough may be dry and hacking, or wet and productive (coughing up sputum). Sometimes the sputum may have blood from the lungs in it.

Coughing can be caused by:

• a tumour blocking the airway tubes (the bronchi) of the lung
• a buildup of fluid around the lungs (called pleural effusion)
• inflammation of the lung caused by radiation therapy (called radiation pneumonitis)
• a lung infection (pneumonia)
• other existing lung problems, such as chronic bronchitis, asthma or chronic obstructive pulmonary disease (COPD)

Treatment will depend on what is causing the coughing. Treatment options may include endobronchial therapies to treat a blockage in the airway or antibiotics to treat infection.

Your healthcare team may have suggestions that can help ease the coughing and improve your quality of life, such as:

• using a humidifier in dry rooms
• trying deep breathing exercises
• clearing your airways using different body positions (called postural drainage)
• using a machine to clear mucus from your airway

If other treatments don't help, your healthcare team may give you opioid medicines to help ease coughing.

Many people with lung cancer have problems with breathing and shortness of breath. This can be a very upsetting symptom that can really affect your quality of life. It can affect work, walking and physical activity, sleeping and other daily activities.

Find out more about difficulty breathing.

Fatigue is a general lack of energy, tiredness or exhaustion. It is different from the tiredness a person usually feels at the end of the day. It is one of the most common side effects of cancer treatment and many people with lung cancer will have fatigue. It may be caused by many of the long-term side effects of lung cancer and its treatment such as coughing, difficulty breathing and pain.

Find out more about fatigue.

A pleural effusion is a buildup of fluid around the lung. This fluid can press on the lung, making it hard to breathe. Many people with lung cancer will develop pleural effusion.

Find out more about pleural effusion.

Weight loss is one of the most common side effects of lung cancer and its treatment. Studies have shown that people with lung cancer who lose a lot of weight don't survive as long as people who keep much of their weight.

One of the main reasons for losing weight is a loss of appetite. Many people with lung cancer lose their appetite because cancer or its treatments can affect the way food tastes and make you not feel like eating. If you don't eat enough, you lose weight.

Eating well can help your body fight disease and cope with the effects of lung cancer treatment. Find out more about loss of appetite, taste changes and eating well when you have cancer.

People with lung cancer are at a higher risk of developing blood clots in the leg (called a deep vein thrombosis or DVT) and in the lung (called a pulmonary embolism). Your healthcare team may treat you with blood thinning medicines to lower the risk of this happening.

A thoracotomy is a difficult surgery that has to cut through or go around many different tissues in the chest, including the skin, muscles, ribs and nerves. You may experience pain after an open thoracotomy, or after a less invasive surgery such as video-assisted thoracic surgery (VATS).

Many people have long-term pain after lung cancer surgery in the areas of the surgical incisions. This is called post-thoracotomy pain syndrome. Many people also have pain in their shoulder on the side that they had their surgery. This type of pain can last for months or even years after surgery.

The exact cause of post-thoracotomy pain isn't known, but it may be caused by nerve or muscle damage during surgery. Shoulder pain may be caused by the chest tubes put in during surgery.

If you're in pain, you may not be able to breathe as deeply as you normally can or cough very much. You may also not be able to move around very much. This can cause mucus to build up in your lungs, causing a lung infection (pneumonia). And being in pain can also cause fatigue, anxiety or depression. Your quality of life suffers when you have chronic pain.

Treatment options may include:

• taking pain medicines
• using anesthetic drugs injected into different nerves (called nerve blocks)

Tell your healthcare team if you are experiencing pain after your lung cancer surgery.

To make decisions that are right for you, ask your healthcare team questions about supportive care.