Immunotherapy and Shortness of Breath: What to Know

Yes, immunotherapy can be linked to shortness of breath, often due to lung inflammation called pneumonitis, and it needs prompt attention. ^[1] Shortness of breath can appear with specific drugs like nivolumab and ipilimumab, sometimes alongside cough, chest pain, or fever. ^[2] Breathing problems during immunotherapy are typically immune‑related side effects, which can range from mild to serious and may require treatment changes. ^[3] Most immunotherapy side effects are manageable when recognized early, but lung involvement can be harmful if not treated quickly. ^[4]

Why Immunotherapy Can Affect Breathing

Checkpoint inhibitors activate the immune system, which can sometimes inflame normal tissues, including the lungs. ^[5] This lung inflammation (pneumonitis) is an established immune‑related adverse event with PD‑1/PD‑L1 therapies. ^[1] Healthcare teams are increasingly recognizing these pulmonary side effects and have developed clinics and protocols to manage them. ^[6]

Key Symptoms to Watch For

Seek urgent evaluation if you notice new or worsening shortness of breath, cough, chest pain, or fever during immunotherapy. ^[2] Pneumonitis symptoms commonly include shortness of breath at rest or with activity and may be accompanied by swelling in the hands or feet. ^[7] A faster heartbeat or difficulty breathing should prompt immediate contact with your care team or emergency services. ^[8]

When to Call Your Care Team

Tell your doctor right away about any breathing changes, as early treatment helps prevent complications. ^[9] Your team may monitor lung function closely during treatment and adjust therapy if needed. ^[2] Some side effects may require altering the dose or schedule of immunotherapy to keep you safe. ^[3]

Medical Management Options

If pneumonitis is suspected, clinicians often use corticosteroids to calm the immune reaction and reduce lung inflammation. ^[10] Depending on severity, your healthcare professional may pause or stop the immunotherapy causing the inflammation. ^[10] Severe cases can need additional treatments and supportive care, guided by standardized protocols. ^[1]

Practical Coping Strategies at Home

Focus on gentle breathing techniques, such as pursed‑lip breathing, to ease air hunger during daily tasks. ^[11] Lean forward to find a comfortable position and pace activities to save energy when shortness of breath flares. ^[12] Let your care team know if symptoms worsen, since there are many options to help manage breathlessness. ^[11]

Other Possible Causes to Consider

• Anemia from cancer treatment can make you feel tired and short of breath and might be treated with transfusion or medication. ^[13]
• Low red blood cell counts commonly present with fatigue and breathlessness and can lead to treatment pauses if severe. ^[14]

How Care Teams Monitor and Support You

Clinics specializing in pulmonary toxicity provide structured assessment and follow‑up for immunotherapy‑related lung issues. ^[6] Experts in checkpoint inhibitor care are trained to manage complex side effects and keep outpatient treatment as safe as possible. ^[15] Patient education materials emphasize recognizing early signs so your team can act quickly. ^[16]

Summary

Shortness of breath can occur during immunotherapy, often from immune‑related pneumonitis, and it’s important to report symptoms early for safe, effective management. ^[1] Most breathing side effects are treatable when recognized promptly, and both medical therapies (like steroids) and home strategies can help. ^[10] Your team will monitor you and may adjust immunotherapy to prevent harm while addressing the root cause. ^[3]