Acupuncture to treat breathlessness in cancer patients

Cancer patients have to deal with a myriad of different symptoms that stem both from the disease itself and the aggressive treatments used to combat cancers. Because cancer cells are mutated versions of normal, healthy cells, many treatment methods used can cause severe side effects as healthy cells are damaged as well as cancerous ones. One of these can be breathlessness, a condition which can impair quality of life, and for which there are a number of different management strategies. In this article we look at one of the methods of dealing with breathlessness in cancer patients: acupuncture.

What causes breathlessness in cancer patients?

Breathlessness is caused by a number of different factors affecting cancer patients. One of the most common is anaemia, which can be caused by chemotherapies (pharmaceutical cancer treatments), radiotherapies (where radiation is used to kill cancers), and some kinds of blood cancer. Anaemia occurs when either the blood cancer or chemotherapy affects the bone marrow, the part of the body which produces red blood cells. This results in a reduction in the number of red blood cells available to transport oxygen and nutrients to cells of the body.

Anaemia causes fatigue and breathlessness, both because of a reduction in red blood cells supplying oxygen.

Sometimes surgery, which is used to remove tumours large enough and accessible enough for direct removal, is used as a cancer treatment, and this can potentially cause breathlessness if a part of the lung is operated upon. Many lung cancers can be excised using a procedure called a lobectomy, which involves removing a section of lung which houses a tumour. In more severe cases a whole long may need to be removed through a procedure called a pneumonectomy, although this is significantly rarer.

Breathlessness does not always result from these treatments. In fact in many cases what’s left of the lungs is healthy enough to function without causing breathlessness.

Certain chemotherapeutic agents can cause inflammation in the lungs which can cause breathing difficulties. Bleomycin is a good example of such a treatment, however this side effect is relatively uncommon and only affects about 10% of patients receiving the drug. In the worst cases, where a person has been receiving bleomycin for an extended period of time, the drug can cause scarring of the lungs (called fibrosis). Your doctor will be very aware of this however, and will ensure that you don’t take enough bleomycin to threaten your lungs.

Another chemotherapeutic agent called interleukin 2 can cause breathing difficulties as well, albeit through a different mechanism. This drug can cause liquids to leak out of the smaller blood vessels in your body, causing a decline in blood pressure which results in swelling that restricts breathing. This is a very rare side effect that typically only affects cancer patients receiving the treatment in large, intravenous doses as opposed to small, subcutaneous doses.

Radiotherapy is an effective lung cancer treatment, however it can cause damage to lung tissues and is therefore used carefully. This particular type of treatment can cause scarring and inflammation, both of which restrict breathing and lead to breathlessness.

Once a tumour reaches a certain size it can severely obstruct breathing. This is a major cause of breathlessness amongst patients with advanced lung cancer. Other causes of breathlessness in cancer patients include heart problems, chest infection, or the build-up of fluids in the lungs.

With so many potential causes for breathlessness, this affliction is a major concern for cancer patients that can affect their livelihood and ability to function on a day to day basis. As such there are a number of management programmes in place designed to help cancer patients deal with the stress of breathlessness.

How is breathlessness usually treated in cancer patients?

A number of coping strategies can help cancer patients deal with breathlessness. One of the main bits of advice provided to people in this situation is to adjust their breathing. Once the breathlessness sets in, a sufferer will feel that they are breathing faster and that they become quite tense in their shoulders and upper body. This may help initially, but over time this typical reaction can make the breathlessness worse. Controlling your breathing so that it is in slow, measured breaths coming in through your nose and out through your mouth is the best way to combat breathlessness.

Other measures that can help include adjusting your living arrangements to minimise any exertion that would cause breathlessness. This would include, for example, moving things you use quite often to the ground floor of your house, using trolleys rather than baskets when shopping, and generally pacing yourself as you go about your day to day life. Small measures like keeping a fan near you help to keep your breathing even and steady. If necessary, your doctor will arrange for you to have an oxygen supply to help your breathing.

Breathlessness caused by an underlying medical issue like the cancer itself, anaemia, or cancer treatment is best addressed by tackling the underlying cause. Anaemia can be treated through blood transfusions, and hopefully if breathlessness is caused by cancer or its treatment then the resolution of the condition will solve the breathlessness.

Many of these coping strategies are beneficial to patients dealing with cancer, however there are instances where standard methods of dealing with a particular symptom or illness aren’t enough. In these cases, an alternative, like acupuncture, can offer a solution.

How is acupuncture used to treat breathlessness in cancer patients?

Studies into whether acupuncture can treat breathlessness suffered by cancer patients are inconclusive so far, more so than research into other areas of acupuncture’s applications in cancer treatment. While there is some evidence to support acupuncture as a remedy for cancer-related fatigue, pain, neuropathy, and hot flushes, breathlessness has thus far proven to be more uncertain.

Some studies into the area have shown success, while others have not observed any significant benefit from the use of acupuncture to treat breathlessness. The only conclusion available to date is that further work is needed to determine whether or not acupuncture can be used to reliably treat breathlessness.

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