Pulmonary Rehab for Lung Cancer

LUNGevity Foundation
Dr. Fogelman

Some people with lung cancer have reduced lung function from their cancer or their treatments, like surgery, radiation, or chemotherapy. People with diminished lung functional capacity or shortness of breath may find pulmonary rehabilitation, a medical program that helps manage breathing, to be a helpful part of their palliative care.

Dr. Patricia Fogelman, DNP, a palliative care provider, talked to us to help us learn more about pulmonary rehab and its benefits.
 

What is pulmonary rehab?

During pulmonary rehab, licensed repository therapies will teach you about your lungs, show you techniques to improve your breathing, and give you strategies to prevent symptoms of shortness of breath before it starts. These strategies span from strengthening exercises to diet and lifestyle changes that help you preserve energy and avoid triggers.
 

What are some things patients might do during rehab?

Exercise is a key piece of pulmonary rehab. The stronger our muscles are, the more efficiently we use oxygen, which helps with shortness of breath. The exercise regimens might include running intervals on a treadmill or riding a stationary bike. It could also be more low impact, such as chair-based yoga. The regimens are tailored to you and increase gradually as you get stronger.

During rehab, your therapist might also suggest changes to your routines to help minimize stress on the body. For example, they might suggest the best way to sequence your morning routine or cluster specific activities you can do seated in order to be most efficient from a breathing perspective.

Your therapist might also cover anxiety management techniques. It’s not uncommon for patients with lung-related disease to become more anxious with breathlessness, and it’s a vicious cycle. You get breathless, which triggers your anxiety, which makes you more breathless, and on and on. We seek to intercept and reroute the energy to prevent the escalation.

Another valuable piece of pulmonary rehab is the monitoring. From day one, your therapists will monitor your vital signs and track progress over time. Seeing tangible progress can help keep you motivated. This can help physically, but also emotionally, which is another important piece of rehab.

Ultimately, this program recognizes that all of you is impacted when you have breathing and lung issues, and thus it works to treat all parts of you. The point is to find a series of interventions that come together to provide the maximum benefit to you.
 

What are the benefits of pulmonary rehab?

It can improve shortness of breath/breathlessness and your ability to eat, drink, and exercise. It helps decrease hospitalizations and visits to the emergency room. It enhances strength that allows you to continue with disease-directed treatments such as surgery, chemo, and radiation.

Pulmonary rehab can also help you gain back a sense of control and restore empowerment, culminating in an improved quality of life and ability to pursue daily activities.
 

Who is pulmonary rehab for?

You are a candidate for pulmonary rehab if you are having trouble breathing or feeling shortness of breath, if you lack strength from lung cancer or its treatments, if exertion makes you fatigued or breathless, or if your breathing issues are affecting your quality of life.

Pulmonary rehab is excellent for people who have had a procedure like surgery, but it’s just as valuable as a maintenance program. If you lose some lung capacity or if you’ve had a setback, you can always come back to rehab and gain back your strength. Staying on track can be easier with this ongoing support and monitoring.
 

Where is pulmonary rehab done?

Primarily, pulmonary rehab is done in a specialty clinic or hospital, either one-on-one or in a small class-like setting. However, there are at-home options, such as telemedicine, home visits, or even following instructions on your own.
 

How can a patient get access to pulmonary rehab?

Talk to your doctor. Tell them what you are feeling, whether it’s that your lung condition has affected your energy levels or your shortness of breath is affecting your quality of life, and that you’re interested in pulmonary rehab. They will refer you to a clinic. If they aren’t sure, you can also ask to be referred to a pulmonary medicine doctor, who will be able to refer you to a clinic.

There is no harm in asking to be referred and completing the initial evaluation.
 

Final thoughts?

Pulmonary rehab does work. It gives people a real, optimized chance to get and stay strong through education, strengthen training, and behavioral changes. Talk to your doctor to learn more about it and find out if pulmonary rehab is right for you.

You can learn more about pulmonary rehab and supportive care from Dr. Fogelman in the session recording from HOPE Summit.

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