Dyspnea management in lung cancer: applying the evidence from chronic obstructive pulmonary disease.
OBJECTIVE
To provide an overview of mechanisms of dyspnea and causes of dyspnea in chronic obstructive pulmonary disease (COPD) and lung cancer and to critically review current pharmacologic and nonpharmacologic management of dyspnea for COPD and lung cancer.


METHODS
Published articles, abstracts, textbooks, and the authors' personal experiences with dyspnea management in COPD and lung cancer.


RESULTS
The causes of dyspnea in cancer are more varied than the causes of dyspnea in COPD; however, many are similar, thus providing the justification for recommending best practice from COPD research to be used in lung cancer. Dyspnea in both diseases is treated by corticosteroids, bronchodilators, antianxiety drugs, local anesthetics, and oxygen. However, when dyspnea is severe, morphine is the first choice. Using specific breathing techniques, positioning, energy conservation, exercise, and some dietary modifications and nutrient supplements can help with dyspnea management.


CONCLUSIONS
Pharmacologic and nonpharmacologic management of dyspnea in COPD can be applied to dyspnea related to lung cancer. Further research in the management of dyspnea in lung cancer is required, particularly controlled studies with larger sample sizes, to determine the effectiveness of the application of COPD dyspnea management in lung cancer.


CONCLUSIONS
Previous studies provide a guideline for applying dyspnea management for COPD to cancer. The theoretical frameworks used in previous studies can be modified for conducting further study.
McCormick Faculty of Nursing, Chiang Mai, Thailand. peeranuch_j@payap.ac.th
Peeranuch
P
Jantarakupt
Davina
D
Porock
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000779:Anesthetics, Local / Q000627:therapeutic use; D014151:Anti-Anxiety Agents / Q000627:therapeutic use; D001993:Bronchodilator Agents / Q000627:therapeutic use; D004417:Dyspnea / Q000209:etiology / Q000451:nursing* / Q000628:therapy*; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications* / Q000451:nursing*; D010102:Oxygen Inhalation Therapy; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications* / Q000451:nursing*; D012307:Risk Factors
D000305:Adrenal Cortex Hormones; D000779:Anesthetics, Local; D014151:Anti-Anxiety Agents; D001993:Bronchodilator Agents