Symptoms - Wheezing

Wheezing (whistling noise while breathing) is one of the most common symptoms experienced in lung cancer patients, particularly those with late stage, or advanced, disease. Estimates range that 40-85% of patients with lung cancer experience respiratory symptoms such as coughing, shortness-shortness of breath, wheezing, and coughing up blood.¹

What causes wheezing?

Wheezing may be caused by pulmonary (related to the lungs) or cardiac (related to the heart) factors. Wheezing is a common cause of dyspnea, which is shortness of breath or difficulty breathing.²

How to treat wheezing

The pulmonary function tests that are necessary to diagnose the cause of wheezing can be exhausting and are often not used in weakened patients with advanced lung cancer. Instead, physicians often start treatment with bronchodilators (such as albuterol), which are medications that relax the muscles in the air tubes leading to the lungs (bronchi), allowing air to pass more easily into the lungs. Bronchodilators are often used in conditions such as chronic obstructive pulmonary disease (COPD) and asthma. If a patient responds favorably to bronchodilators, pulmonary function tests are not necessary.^2,3

Besides lung cancer, wheezing may also be caused by COPD, asthma, or congestive heart failure. In patients with lung cancer that also have other conditions like these, the underlying condition is treated to help alleviate wheezing.³

Palliative care can help

Experiencing wheezing when breathing is distressing, and respiratory symptoms can become worse as lung cancer becomes more advanced. Palliative care is a specialized field that aims to alleviate symptoms and maximize the patient’s quality of life. Palliative care does not focus on curing the disease or prolonging life, which is the goal of other cancer treatments, such as chemotherapy. However, palliative care is an important part of the patient’s treatment plan and encompasses physical symptoms, psychosocial distress, spiritual distress, and caregiver distress.⁴

Because of the close association of wheezing and dyspnea, therapy used for alleviating dyspnea can also help relieve wheezing. Palliative care measures may include oxygen therapy, breathing techniques, opioids (pain medications), and anti-anxiety medications. Some patients have also found relief with complementary therapies such as acupuncture, acupressure, and relaxation techniques.^4,5

Additional symptoms of lung cancer

While wheezing is one of the most common symptoms in lung cancer, others include:

• Persistent coughing
• Shortness of breath
• Chest pain that worsens with deep breathing, coughing or laughing
• Hoarseness
• Weight loss
• Loss of appetite
• Fatigue or feeling weak
• Respiratory infections (like bronchitis or pneumonia) that don’t go away or keep returning⁶