The symptomatic relief of dyspnea.
Dyspnea is a common symptom that causes considerable suffering in cancer patients. Although some knowledge of the sensory information that is transduced to the brain during dyspnea exists, we still have only a rudimentary understanding of the subjective perception of this symptom. There appear to be many parallels between pain and dyspnea. Consistent with this fact, there is growing evidence that opioids are safe and effective and should be considered front-line therapy for symptomatic relief of dyspnea. In addition to opioids, there are other important pharmacologic and nonpharmacologic tools with varying degrees of support that can be considered for symptomatic relief. Importantly, because dyspnea is a subjective symptom that occurs in a unique individual, the optimal treatment of dyspnea will always entail an understanding of, and support for, a patient's other sources of psychosocial, spiritual, and/or existential suffering.
Elia
Giovanni
G
San Diego Hospice and Palliative Medicine, 4311 Third Avenue, San Diego, CA 92103, USA.
Thomas
Jay
J
D004417:Dyspnea / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy*; D006801:Humans; D009369:Neoplasms / Q000150:complications*; D010166:Palliative Care
Proc Natl Acad Sci U S A. 2001 Feb 13;98(4):2041-6
11172072
Eur J Heart Fail. 2002 Dec;4(6):753-6
12453546
Proc Natl Acad Sci U S A. 1999 Mar 2;96(5):2532-7
10051677
Brain. 1999 Sep;122 ( Pt 9):1765-80
10468515
Am Rev Respir Dis. 1987 Jul;136(1):58-61
3605841
Chest. 2004 May;125(5):1783-90
15136391
Ann Intern Med. 1993 Nov 1;119(9):906-7
8215003
Clin Sci (Lond). 1988 Mar;74(3):275-81
3345636
Pulm Pharmacol Ther. 2002;15(4):363-8
12220941
Pain. 2002 Mar;96(1-2):3-8
11932055
Am J Respir Crit Care Med. 2000 Sep;162(3 Pt 1):971-5
10988115
J Pain Symptom Manage. 2002 Jan;23(1):73-6
11779672
J Pain Symptom Manage. 1999 Apr;17(4):256-65
10203878
Neuroreport. 2000 Jul 14;11(10):2117-20
10923655
J Pain Symptom Manage. 1998 Oct;16(4):212-9
9803048
Pain. 1979 Jun;6(3):305-327
460936
Respir Physiol. 1989 Apr;76(1):53-67
2499025
BMJ. 2003 Sep 6;327(7414):523-8
12958109
Am J Respir Crit Care Med. 1995 Mar;151(3 Pt 1):751-7
7881666
J Cardiopulm Rehabil Prev. 2007 Jul-Aug;27(4):237-44
17667021
Am J Respir Crit Care Med. 2004 May 1;169(9):1028-33
14977622
Chest. 1986 Dec;90(6):832-6
3780329
J Neurophysiol. 2007 Feb;97(2):1396-404
16870842
Am J Respir Crit Care Med. 2000 Jun;161(6):1963-7
10852774
J R Soc Med. 1989 May;82(5):264-7
2474072
J Appl Physiol (1985). 1988 Jan;64(1):371-6
3128527
Am Rev Respir Dis. 1988 Jun;137(6):1285-8
3144198
Brain. 1998 May;121 ( Pt 5):931-47
9619195
Brain Res Bull. 1998 Dec;47(6):625-42
10078619
Thorax. 1993 Apr;48(4):339-43
7685550
Thorax. 2002 Nov;57(11):939-44
12403875
Chest. 1986 Feb;89(2):234-6
3943383
Q J Med. 1980 Winter;49(193):9-20
6776586
J Pain Symptom Manage. 2006 Jan;31(1):38-47
16442481
Pain. 2005 Dec 5;118(3):306-318
16289802
J Appl Physiol (1985). 1993 Feb;74(2):590-5
8458774
Palliat Med. 2003 Dec;17(8):659-63
14694916
Respir Physiol Neurobiol. 2007 Apr 16;156(1):1-8
16935035
J Am Coll Cardiol. 1997 Jan;29(1):147-52
8996307
AJNR Am J Neuroradiol. 1999 Nov-Dec;20(10):1920-4
10588119
Heart. 2003 Sep;89(9):1085-6
12923038
Palliat Support Care. 2006 Sep;4(3):287-93
17066970
Am J Respir Crit Care Med. 2001 Mar;163(4):951-7
11282772
Proc Natl Acad Sci U S A. 1999 Apr 13;96(8):4569-74
10200303
Proc Natl Acad Sci U S A. 2001 Feb 13;98(4):2035-40
11172071
Clin Sci (Lond). 1987 Jun;72(6):693-8
3595075
Br Med J (Clin Res Ed). 1981 Aug 1;283(6287):343-6
6788319
Life Sci. 2000;66(23):2221-31
10855942
Ann Neurol. 1998 Nov;44(5):811-5
9818938
Proc Natl Acad Sci U S A. 2001 Feb 13;98(4):2029-34
11172070
Pulm Pharmacol Ther. 2007;20(4):433-7
17336558
Psychophysiology. 2006 Jul;43(4):382-6
16916434
Ann Oncol. 1999 Dec;10(12):1511-4
10643545
Am J Respir Crit Care Med. 1999 Jan;159(1):321-40
9872857
Heart. 2006 Jan;92(1):12-6
16159969
Am Rev Respir Dis. 1989 Jan;139(1):126-33
2492170
Palliat Med. 1994;8(1):35-8
7514070
Pain. 2002 Feb;95(3):195-199
11839418
Pain. 1997 Dec;73(3):431-445
9469535
Am Rev Respir Dis. 1993 Nov;148(5):1351-7
8239175
Pain. 1979 Jun;6(3):283-304
460935
J Appl Physiol (1985). 1991 Dec;71(6):2183-90
1778911
Br J Clin Pharmacol. 1985 Jun;19(6):793-7
4027121
Lancet. 1986 Dec 20-27;2(8521-22):1416-9
2878274
J Neurophysiol. 2002 Sep;88(3):1500-11
12205170
Clin Sci (Lond). 1981 Oct;61(4):429-39
6793277
BMJ. 1999 Apr 3;318(7188):901-4
10102851
J Pain Symptom Manage. 2006 Dec;32(6):541-50
17157756