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Breathlessness in cancer patients - implications, management and challenges
Shirley Thomas1, Claudia Bausewein, Irene Higginson
1Addenbrookes Hospital, Palliative Care Team, Cambridge CB2 2QQ, UK. shirleythomas30@yahoo.co.uk
Purpose Of The Review:
Breathlessness in patients with advanced cancer is common. It remains a difficult symptom to improve despite recent advances in cancer treatment and the increasing evidence available. Patients and carers experience a high level of distress from this frightening symptom. There is a greater volume of evidence to guide the management of breathlessness accompanying advanced non-malignant disease, as opposed to malignant disease, as most research has been conducted in this group. This article reviews the management of breathlessness in patients with cancer.
Methods:
A systematic review of the literature in this area was completed. The results of the research work carried out by co-authors were also reviewed. The following databases were searched: MEDLINE, CINAHL, EMBASE, PsycINFO, the Cochrane Library. This search strategy was supplemented by hand-searching references in relevant palliative care text books and by searching relevant websites.
Key Results:
Pharmacological and non-pharmacological measures to alleviate breathlessness are discussed in this paper. Non-pharmacological approaches are discussed in detail as these are currently the most effective for the greatest number of patients.
Conclusions:
The cause of breathlessness in advanced cancer patients is usually multifactorial. A combination of pharmacological with non-pharmacological approaches is essential to manage breathlessness. Breathlessness services (e.g. Breathlessness Intervention Service) can be considered to be innovative and effective models of care when provided as part of a network of services aimed at helping patients with advanced cardiorespiratory disease, including patients with advanced cancer.
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