Shortness of breath, chest pain, and coughing — these are all symptoms of lung cancer. But did you know they can also occur with a collapsed lung? Known as atelectasis, this complication affects the tiny air sacs in the lungs. People with lung cancer may develop atelectasis due to tumor growth or cancer treatments.

In this article, we’ll cover what atelectasis is, why it develops in lung cancer, and how your oncologist (cancer specialist) may treat it. If you’re concerned about developing atelectasis or think you may have it, be sure to talk to your doctor.

What Is Atelectasis?

“Atelectasis” is the medical term used to describe the collapse of one or more parts of the lung. To better understand how atelectasis develops, it helps to know about the lungs’ structures.

Your lungs are made of parts called lobes. Your right lung has three lobes, and your left lung has two. When you breathe in, air travels from your trachea (windpipe) into the bronchial tubes. These large airways branch into smaller bronchi within your lungs. The air then travels into even smaller airways known as bronchioles. At the end of each bronchiole, there are alveoli (tiny inflated air sacs). Alveoli move oxygen from your lungs into your bloodstream.

Atelectasis develops when your alveoli collapse. This can occur when you aren’t breathing enough to inflate the air sacs. You may also develop atelectasis if outside pressure pushes on the alveoli, causing them to deflate. Some people may have atelectasis in only one lobe, but it can also affect the entire lung.

Atelectasis vs. Pneumothorax

Atelectasis isn’t the only condition that causes a collapsed lung. A pneumothorax occurs when air leaks into the space between your lung and pleural space (chest wall). The air puts extra pressure on the lung, causing it to partially or completely collapse or deflate. A pneumothorax can become a medical emergency — it’s important to seek medical care immediately if you think you have a collapsed lung.

Symptoms of Atelectasis

You likely won’t experience any symptoms of atelectasis if your case is mild. If entire lobes are affected, your oxygen levels may drop. This can cause noticeable symptoms, including:

• Shortness of breath or unusually fast breathing
• Chest pain
• A cough
• Bluish or darker brown skin and lips

Diagnosis of Atelectasis

Doctors use several tests to diagnose atelectasis. Imaging tests like chest X-rays and computed tomography (CT) scans help doctors take a closer look at lung tissue.

A bronchoscopy may also be used to look inside airways for tumors blocking airflow. This test uses a long, flexible tube with a camera attached to take pictures of your bronchi. Your doctor may also perform a biopsy, removing a tissue sample of tumors or suspicious areas to examine in a lab.

What Causes Atelectasis in Lung Cancer?

Atelectasis is a potential complication of lung cancer and its treatments. Your oncologist can discuss your individual risk of atelectasis.

Lung Cancer as a Cause of Atelectasis

Obstructive atelectasis occurs when a blockage in your airways prevents air from reaching your alveoli. If a lung tumor forms inside your airways, it may cause your alveoli to collapse.

A type of cancer known as lung adenocarcinoma (previously known as bronchoalveolar carcinoma, or BAC) develops in the alveoli. This can cause replacement atelectasis — one of the most severe forms. Replacement atelectasis occurs when tumor tissue replaces all the alveoli in a lung lobe. People with this complication may experience a complete lung collapse.

Pleural effusion — fluid buildup between the lungs and chest wall — may also cause atelectasis. People with lung cancer can develop a malignant pleural effusion if the cancer spreads into the pleural space. The fluid buildup puts pressure on the lungs, causing them to collapse.

Lung Cancer Treatment as a Cause of Atelectasis

Surgery is one of the most common treatments for early-stage lung cancer. However, studies have found that people may develop pulmonary (lung) complications afterward. The most common complications include:

• Atelectasis
• Pneumonia (lung infection that causes inflammation in the alveoli)
• Empyema (a pocket of pus in the lung tissue)

One study discussed in the Journal of Thoracic Disease found that out of about 1,100 people who had lung cancer surgery, 6.4 percent developed atelectasis.

The Link Between Atelectasis and Better Survival

Interestingly, researchers have found that atelectasis may be associated with better overall survival in lung cancer. Several studies showed that people with atelectasis and lung cancer — especially those with locally advanced (stage 3) lung cancer — live longer than those without atelectasis. Other findings have linked atelectasis with better survival in both non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC).

However, atelectasis is also linked with an increased risk of complications. If left untreated, atelectasis can lead to acute respiratory failure — meaning your lungs can’t provide enough oxygen for your body. This is a serious medical condition that requires emergency treatment. Atelectasis may also cause pneumonia.

How Is Atelectasis With Lung Cancer Treated?

Atelectasis treatment depends on how severe your symptoms are. Most people with atelectasis don’t need treatment because the condition resolves on its own.

Those with lung tumors blocking their airways likely need a bronchoscopy or surgery. Removing your lung tumor opens your airways so that air reaches your alveoli. You might need additional treatment with radiation therapy or chemotherapy to shrink your tumor.

Deep breathing exercises help collapsed lungs return to their original size. Your doctor may have you use a handheld device called an incentive spirometer to use during these exercises. Other treatment options include medications to help open your airways and physical therapy for expanding your lungs.

Talk With Others Who Understand

On MyLungCancerTeam — the social network for people with lung cancer and their loved ones — more than 12,000 members come together to ask questions, give advice, and share their stories with others who understand life with lung cancer.

Do you have atelectasis and lung cancer? How do you manage the symptoms of these two conditions? Share your experience in the comments below, or start a conversation by posting on your Activities page.