Management of Dyspnea and Cough in Patients With Cancer

Dudgeon, Deborah; Rosenthal, Susan

doi:10.1016/s0889-8588(05)70332-4

Cited by 46 publications

(27 citation statements)

References 59 publications

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“…The current results from the logistic analyses showed that depression at 3 months after surgery had a positive correlation with pain and performance status at 3 months after surgery (Table 4B). This finding was consistent with several studies in which disease‐related physical variables, such as pain, dyspnea, and performance status, were reported to be significantly correlated with quality of life in cancer patients 9, 12, 28, 29. Fortunately, although performance status and dyspnea worsened during the 3 months after surgery, they returned to preoperative levels by 6 months 5.…”

Section: Discussionsupporting

confidence: 91%

Depression after successful treatment for nonsmall cell lung carcinoma

Uchitomi

Mikami

Kugaya

et al. 2000

Cancer

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Section: Discussionsupporting

confidence: 91%

Depression after successful treatment for nonsmall cell lung carcinoma

Uchitomi

Mikami

Kugaya

et al. 2000

Cancer

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“…Dyspnea and other respiratory symptoms have been reported to negatively impact QOL in those with COPD and other chronic lung conditions, 2-8 but little information is available about the impact on people with cancer. 9 One study 10 suggests that patients with NSCLC may actually have better QOL than those with severe COPD.…”

mentioning

confidence: 99%

Impact of Respiratory Symptoms and Pulmonary Function on Quality of Life of Long-term Survivors of Non-Small Cell Lung Cancer

Sarna

Evangelista

Tashkin

et al. 2004

Chest

208

153

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Purpose: To describe respiratory symptoms and pulmonary function among long-term survivors of non-small cell lung cancer (NSCLC), and their relationship to quality of life (QOL). Methods: Cross-sectional survey of disease-free, 5-year minimum survivors of NSCLC (n ‫؍‬ 142; 54% women; average age, 71 years); the majority (74%) had received a lobectomy. Analysis included frequency of self-reported respiratory symptoms (cough, phlegm, wheezing, breathlessness) as measured by the American Thoracic Society questionnaire, pulmonary function findings from hand-held spirometry, and QOL (Short Form-36). Results: Two thirds of survivors reported at least one respiratory symptom (mean, 1.3; SD, 1.2): 25% cough, 28% phlegm, 31% wheezing, and 39% dyspnea. Twenty-one percent reported that they spent most of the day in bed in the past 12 months because of respiratory symptoms. Average FEV 1 percentage predicted was 68% (SD, 23); 21% had < 50% predicted FEV 1 . Based on spirometry results, 36% had a moderate/severe obstructive and/or restrictive ventilatory disorder. Survivors exposed to second-hand smoke (28%) were more than three times as likely to report respiratory symptoms. Respiratory symptom burden contributed to diminished QOL in several domains. Conclusions: The majority of these survivors experienced respiratory symptoms, and more than one third reported dyspnea, including one of five patients with seriously diminished pulmonary function. Symptom burden, rather than ventilatory impairment, contributed to diminished QOL. Further study is needed to determine the patterns and effective management of posttreatment respiratory symptoms on survivors of lung cancer. (CHEST 2004; 125:439 -445)Key words: cancer survivors; chronic lung disease; lung neoplasms; pulmonary function; quality of life; respiratory symptoms; tobacco, smoking Abbreviations: ATS ϭ American Thoracic Society; df ϭ degrees of freedom; FEF 25-75% ϭ maximum expiratory flow rate; NSCLC ϭ non-small cell lung cancer; QOL ϭ quality of life; SF-36 ϭ Short Form-36 T he long-term consequences of the curative treatment for non-small cell lung cancer (NSCLC) on pulmonary status, the frequency of respiratory symptoms, and the impact of these pulmonary consequences on the quality of life (QOL) of such survivors have not been previously reported. Respiratory distress, even among the 14% of patients with NSCLC who are disease-free survivors, 1 may negatively affect QOL. Dyspnea and other respiratory symptoms have been reported to negatively impact QOL in those with COPD and other chronic lung conditions, 2-8 but little information is available about the impact on people with cancer. 9 One study 10 suggests that patients with NSCLC may actually have better QOL than those with severe COPD.*From the School of Nursing (Drs. Sarna and Evangelista),

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“…Both inhaled and systemic opioid receptor agonists have been shown to be effective for dyspnea relief. The site of action is unknown 86,87 . It has been shown that inhaled opioids can provide dyspnea relief even in patients already receiving much higher doses via other routes for analgesia.…”

Section: Therapeutic Alleviation Of Dyspneamentioning

confidence: 99%

The neurophysiology of dyspnea

Mellema

2008

J Vet Emergen Crit Care

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Objective -To review the human and veterinary literature regarding the neurophysiology of dyspnea and to provide evidence for the beneficial effects of several novel therapies aimed at the alleviation of dyspneic sensations. Data Sources -Data sources included scientific reviews, case reports, original research publications, and recent research conference proceedings. Human Data Synthesis -The use of blood oxygenation level-dependent functional magnetic resonance imaging technology has revealed that the brain regions activated by air hunger in humans are also those activated by fear, pain, and thirst perception. In human subjects, it has been found that agents known to enhance the firing of pulmonary slowly adapting receptors (SARs) can alleviate the sensation of dyspnea without altering central respiratory drive. Several small studies have also shown that nebulized opioids can reduce the sensation of dyspnea apparently via activation of peripheral opioid receptors in the lung. Veterinary Data Synthesis -There are several animal models relevant to both small and large animal clinical patient populations. Treatment of rats with a nebulized SAR sensitizing agent (furosemide) enhances SAR firing in response to lung inflation. Behavioral escape responses to airway occlusion are reduced in lightly anesthetized cats when treated with nebulized furosemide. Opioid agonists have been shown to inhibit the release of acetylcholine and other mediators from the airways of dogs and guinea pigs. Studies using a goat model with bilateral destruction of the pre-Bö tzinger Complex do not support current paradigms of air hunger origination. Conclusions -Veterinary patients may benefit from an approach to dyspnea that incorporates an understanding of the origins of the unpleasant sensations associated with the condition. Several novel therapies have shown promise in alleviating dyspneic sensations without altering respiratory drive. Further study is needed to determine the safety and efficacy of these therapies in veterinary patients.

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Management of Dyspnea and Cough in Patients With Cancer

Cited by 46 publications

References 59 publications

Depression after successful treatment for nonsmall cell lung carcinoma

Depression after successful treatment for nonsmall cell lung carcinoma

Impact of Respiratory Symptoms and Pulmonary Function on Quality of Life of Long-term Survivors of Non-Small Cell Lung Cancer

The neurophysiology of dyspnea

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