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Is Shortness of Breath Normal With Leukemia?

Posted on April 29, 2022
Medically reviewed by
Richard LoCicero, M.D.
Article written by
Maureen McNulty

People with leukemia commonly experience shortness of breath, also called dyspnea. This symptom occurs when you feel like you can’t take in a full breath of air.

Shortness of breath may feel like a little bit of breathlessness, or it may be more extreme, making you feel like you are suffocating. It can also be accompanied by feelings of weakness or tightness in the chest, a faster heart rate, or clammy skin. You may feel short of breath only while doing an activity such as exercising or talking. You may notice this sensation even when you are resting.

About 1 out of 3 people experience breathlessness during the early stages of leukemia. People with any type of leukemia can develop this symptom.

Many members of MyLeukemiaTeam have experienced shortness of breath. This often leads to a worse quality of life. “The leukemia complicates everything due to fatigue and shortness of breath,” wrote one member. “I am trying to remain positive and see slow progress daily.” Another member added, “I get so tired and short of breath. Cleaning around the house is too overwhelming.”

Potential Causes of Shortness of Breath

People living with leukemia may experience shortness of breath for many reasons. Shortness of breath is most often caused by leukemia itself. It may also be caused by leukemia treatments, other health conditions, or other external factors.

Anemia

For people with leukemia, shortness of breath is often caused by anemia.

Anemia is a condition that leads to low levels of red blood cells. These cells are responsible for carrying oxygen around the body. The body is constantly making new blood cells as old or damaged cells die.

In people with leukemia, cancer cells can fill up the bone marrow, the tissue inside of certain bones where new blood cells are made. As a result, the body can’t make as many new red blood cells.

Besides shortness of breath, symptoms of anemia include:

  • Tiredness or weakness
  • Dizziness
  • Abnormal heart rhythms
  • Chest pain
  • Headaches
  • Cold hands or feet
  • Pale or yellowish skin
  • Trouble concentrating or focusing

Anemia and breathing problems can appear in any type of leukemia. People with faster-growing types of leukemia — acute myeloid leukemia and acute lymphoblastic leukemia — may experience shortness of breath during the early stages of their condition.

Those with types of leukemia that come on more slowly, such as chronic myeloid leukemia (CML) and chronic lymphocytic leukemia, may not experience shortness of breath until later stages, when their condition gets worse.

Leukemia Treatment Side Effects

Shortness of breath can be a side effect of treatments like chemotherapy, targeted therapy, or radiation. You may want to ask your doctor whether your cancer treatments are known to lead to difficulty breathing.

Drugs like chemotherapy can kill cancer cells, but they also destroy many of the body’s healthy blood cells. These treatments can cause anemia, leading to shortness of breath.

They may also kill white blood cells, which are important for fighting germs. Low levels of white blood cells can increase your risk of infections. Lung infections like pneumonia may lead to breathing problems.

In rare cases, the targeted therapy drugs used to treat CML can cause fluid to build up in the lungs, leading to shortness of breath. “I am taking imatinib (Gleevec), and I am short of breath lately,” said one MyLeukemiaTeam member with CML. Another member taking bosutinib (Bosulif) commented, “Shortness of breath comes and goes. Always tired.”

Radiation therapy to the chest can also lead to shortness of breath because it leads to lung inflammation. Radiation treatments are not often used as a part of leukemia treatment, but they may be used in certain situations. For example, a person may receive total body irradiation before undergoing a stem cell transplant. In rare cases, radiation may be used to treat cancer cells that have spread to certain bones, or to treat tumors that are pressing against the airways.

Having Other Health Conditions

Shortness of breath can also be a symptom of other medical conditions that may occur alongside leukemia, such as:

  • A chest infection such as pneumonia
  • Low blood pressure levels
  • Lack of physical fitness
  • A panic attack
  • Anxiety
  • A heart attack
  • Heart disease
  • A pulmonary embolism (a blood clot that develops in the lungs)
  • Lung conditions such as asthma or chronic obstructive pulmonary disease
  • Carbon monoxide poisoning

Some MyLeukemiaTeam members have found that their shortness of breath was caused by other conditions besides their cancer. “I have told my doctor about the shortness of breath, and he says it’s my anxiety,” one member wrote.

Other Factors

You can also experience shortness of breath as a result of other external factors. Spending time at high altitudes can sometimes cause this symptom. Breathlessness also may be caused by intense physical activity or extreme temperatures. People who smoke cigarettes may also develop breathing problems such as shortness of breath.

Other factors could also impact breathlessness. “Rain and humidity make it more difficult sometimes,” one MyLeukemiaTeam member reported.

Treating Shortness of Breath

When you notice that you are feeling out of breath, there may be a few things you can do to make breathing easier:

  • Sit up straight, or prop your upper body up to a 45 degree angle while lying down.
  • Practice pursed-lip breathing. Inhale slowly through your nose, pucker your lips as if you were going to blow out a candle, and then breathe out as much air as possible. Try to make your exhales twice as long as your inhales.
  • Sit up with your feet on the floor or a stool. Place your arms on a tray table or side table in front of you, and tilt your head forward.

You can also ask your doctor if there are any treatments that will help you breathe better. Your doctor may be able to prescribe oxygen therapy, inhalers, nebulizers (machines that deliver medication in the form of a mist that you inhale), or other medications that reduce inflammation in your lungs or help open your airways.

Treating the Causes of Breathlessness

In the long term, you can improve this symptom by addressing its underlying cause. For example, anemia may be treated with iron infusions (a treatment in which iron is given directly into your veins). Red blood cell transfusions (a procedure in which you receive new red blood cells from a donor) and medications like erythropoiesis-stimulating agents may also help.

Your doctor may recommend taking antibiotics to prevent or treat infections, including chest infections. You may also take medications such as growth factors to raise your white blood cell counts.

If your shortness of breath is caused by a leukemia treatment, you may be able to talk to your doctor about switching to a different medication. Some MyLeukemiaTeam members reported different side effects while trying different treatments. One member with CML wrote, “If shortness of breath is there, call your doctor. Dasatinib (Sprycel) did the same thing to me. What works for one person doesn’t always work for another.”

Other health conditions that cause shortness of breath are treated in different ways. Work with your doctor to describe your symptoms and come up with solutions that work for you.

“It seems my shortness of breath was asthma-related,” said one member. “Breathing a sigh of relief. For now, all I need is an inhaler several times per day.”

Is Shortness of Breath Serious?

Shortness of breath may not always seem serious. Some people with this symptom dismiss it as a sign that they’re not as physically fit as they used to be. However, breathlessness can sometimes be a sign that there is a more serious underlying problem.

One of the most serious forms of shortness of breath is breathlessness that appears quickly, out of the blue. This can sometimes be a sign of something serious, such as a heart attack. Seek emergency medical care — such as calling 911 — if you have sudden shortness of breath along with other worrying symptoms such as chest tightness, trouble talking, dizziness, or blue-tinged skin or fingernails.

Even when breathing problems don’t signal a major problem, it is still important to let your health care team know what is going on. Changing symptoms may be a sign that your leukemia is getting worse or that you are experiencing another health problem. Tell your doctor if:

  • Shortness of breath comes on suddenly and unexpectedly.
  • You become breathless while performing easy tasks that previously didn’t cause you any problems.
  • You have shortness of breath that lasts for a month or more, or gets worse over time.
  • Coughing symptoms appear along with shortness of breath.

MyLeukemiaTeam members have reported talking to their doctor about their breathing problems. “The last time I was at the oncologist, she asked me, ‘Are you short of breath?’” said one member. “Be sure to let your oncologist know about this. It’s important you do.”

Talk With Others Who Understand

MyLeukemiaTeam is the social network for people with leukemia and their loved ones. On MyLeukemiaTeam, more than 10,500 members come together to ask questions, give advice, and share their stories with others who understand life with leukemia.

Do you experience shortness of breath? Share your experiences in the comments below, or start a conversation by posting on your Activities page.

All updates must be accompanied by text or a picture.
Richard LoCicero, M.D. has a private practice specializing in hematology and medical oncology at the Longstreet Clinic Cancer Center, in Gainesville, Georgia. Review provided by VeriMed Healthcare Network. Learn more about him here.
Maureen McNulty studied molecular genetics and English at Ohio State University. Learn more about her here.

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