Surgery, chemotherapy, and radiation are the foundations of lung cancer treatment. These therapies can slow or stop cancer. But they don’t address things like treatment side effects or the emotional and physical toll that cancer can take on you.
While treatment can help you live longer with lung cancer, pulmonary rehabilitation helps you live better. It works alongside cancer treatment to help you feel more comfortable, heal after surgery, and manage cancer more effectively.
Pulmonary rehabilitation is an educational, exercise-based program for people with chronic lung conditions who experience breathing problems.
It was originally designed for people with chronic obstructive pulmonary disorder (COPD), but it’s been expanded to fit the needs of people with other conditions, like lung cancer.
Who should try it?
According to the American Lung Association, pulmonary rehabilitation is recommended if you live with lung disease and, despite treatment, experience shortness of breath often enough that it interferes with your daily activities. It may also be helpful before and after surgery for lung cancer.
It’s common for people with lung cancer to experience fatigue and difficulty breathing. Pulmonary rehabilitation for lung cancer is designed to teach you more about your condition and help you cope with these symptoms.
A big part of this includes learning exercises to help you breathe more comfortably, increase your overall fitness, and improve your ability to manage lung cancer in general.
During pulmonary rehabilitation sessions, you may:
- practice breathing techniques
- learn how to use oxygen therapy to prevent shortness of breath
- do exercises to strengthen your heart, lungs, and muscles
- get tips for daily living
- learn how to manage your medications
- get help to quit smoking
- get advice on healthy eating
- find emotional support
Every pulmonary rehabilitation team includes a group of specialists. Your care team will likely include all or some of the following people:
- doctors
- nurses
- respiratory therapists
- a physical therapist or other exercise specialist
- an occupational therapist
- a dietitian
- a social worker
- a psychologist or counselor
Your oncologist or whoever leads your team will create a program for you based on your goals. The other members of your team will work in tandem to teach you the skills you need to manage cancer more effectively.
Some pulmonary rehab programs take place in a hospital or clinic. Others you can do at home once you have instructions. You’ll stay in touch with your treatment team using your smartphone, computer, or activity monitors.
If the program is in person, expect to go two or three times per week. Because you’ll be learning about different topics and doing varied tests and exercises, program sessions may not take place in the same location every time.
It takes 6 to 12 weeks of pulmonary rehabilitation to see improvements in breathing ability or stamina.
Pulmonary rehab starts with an evaluation, which can include:
- a medical history and review of your symptoms
- lung function tests
- measurements of your oxygen level, blood pressure, and heart rate
- tests of your walking ability
A member of your healthcare team will use the results of these tests to design the best plan for you. You may do some of the same tests again at the end of the program. This helps your healthcare team track your progress.
A typical pulmonary rehabilitation program for lung cancer includes the following activities.
Education
You’ll learn more about lung cancer and how to manage it with:
- medication
- breathing techniques
- supplemental oxygen
Breathing techniques
A respiratory therapist will teach you techniques like pursed lip breathing and diaphragmatic breathing (breathing from your belly). These methods will help you gain more control over your breathing, get more oxygen into your lungs, and make you feel less out of breath. You’ll also learn how to use supplemental oxygen if you need it.
Exercise
You’ll take part in a supervised exercise program to strengthen your heart and muscles, increase your energy levels, and help you breathe more efficiently. You’ll also learn to pay attention to your breathing and oxygen levels as you exercise. Programs should include the option for modifications to help you exercise safely and comfortably.
Task management
You’ll learn ways to conserve energy and perform your daily activities with less shortness of breath.
Counseling
A lung cancer diagnosis can bring about anxiety and depression. Your therapist or counselor can teach you how to cope with the stress and anxiety of living with cancer, which can sometimes even affect your breathing.
Nutritional advice
Lung cancer and its treatments can cause unintended weight loss and loss of appetite. You’ll learn how to choose and prepare healthy foods in the right amounts to keep your weight within the range your oncologist recommends. A dietitian can also give you tips to make it easier to eat when you’re short of breath.
Pulmonary rehabilitation can help you:
- manage symptoms like shortness of breath, fatigue, and depression
- improve your lung function enough to qualify for surgery
- improve your ability to exercise, perform daily activities, and stay active
- recover and manage side effects after surgery or other cancer treatments
- stay healthy enough to avoid a hospital stay
- relieve anxiety and depression
A program may also give you access to a whole community of people who have experienced what it’s like to live with lung cancer. You can learn from and lean on each other.
Pulmonary rehabilitation is generally considered safe, especially when done in partnership with an experienced care team.
Though rare, it’s possible that you could injure your muscles or bones during the program’s exercise activities, according to the Heart, Lung, and Blood Institute at the
Insurance coverage varies for pulmonary rehabilitation. Most private health insurance plans and Medicare will cover some or all of the cost, as long as your doctor prescribes it and you meet certain requirements.
It’s likely you’ll have a copay. According to the American Association of Cardiovascular and Pulmonary Rehabilitation, expected copays for each session of pulmonary rehabilitation were around $5 to $25 in 2021 under Medicare, though this varied based on what was done during the session and where it took place.
Under Medicare, you’ll pay 20 percent of the Medicare-approved rate paid to the doctor, plus a copay if the session happens in an outpatient hospital setting.
Because this type of rehab program was first designed for COPD, private insurance plans may be set up to cover it only for this condition, though some do offer coverage for lung cancer and before or after lung surgery.
Before starting, check with your insurance plan to find out what kind of coverage it offers, how many sessions are covered, and if you’ll have to pay anything out of pocket.
Keep in mind many places offer financial assistance to help with the costs of treatment. Nonprofit hospitals and organizations like the Patient Advocate Foundation may be especially good resources for this.
Pulmonary rehabilitation might be a good fit for you if lung cancer symptoms like shortness of breath interfere with your daily activities. It may also be recommended to you if you’re undergoing surgery for lung cancer.
Ask your oncologist whether you qualify for one of these programs. They should be able to recommend a rehab program in your area. You should also look into costs and consider calling your insurance provider to see if they offer coverage.