title: Assessment of dyspnea in terminally ill cancer patients: role of the thoracic surgeon as a palliative care physician.
abstract: BACKGROUND
  Many cancer patients suffer from rapidly-progressing dyspnea that is difficult to relieve.
  
  
  METHODS
  The subjects were 26 patients who had dyspnea that was difficult to relieve. The Numeric Rating Scale was used to evaluate their dyspnea. For all patients, the cause of the dyspnea was investigated by CT and x-rays.
  
  
  RESULTS
  The principal causes of the dyspnea were pleural effusion that increased daily, complications from pneumonia, massive ascites, multiple metastatic lung tumors and atelectasis, recurrent laryngeal nerve paralysis and narrowing secondary airway compression. Dyspnea was caused by a variety of conditions that overlapped over time, intensifying patients' discomfort. Among 14 patients for whom we recommended treatment with sedation, only 8 of them consented. Among the patients who were treated with sedation, the median interval between the exacerbation of dyspnea and death was 16 days; among non-sedated patients it was 18 days.
  
  
  CONCLUSIONS
  Palliative care physicians who specialize in the respiratory system can, to some extent, predict the occurrence of rapidly progressive dyspnea in cancer patients. It is important to explain the methods of relieving dyspnea to the patient, the patient's family, and the oncologist early, so that decisions on how to manage dyspnea can be made in advance.
authors.affiliation: Division of General Thoracic Surgery, Dept. of Surgery, Tokai University School of Medicine.
authors.forename: Kazuho
authors.initials: K
authors.lastname: Yoshino
authors.forename: Noboru
authors.initials: N
authors.lastname: Nishiumi
authors.forename: Ryota
authors.initials: R
authors.lastname: Masuda
authors.forename: Yuki
authors.initials: Y
authors.lastname: Saito
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Tokuda
authors.forename: Masayuki
authors.initials: M
authors.lastname: Iwazaki
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004417:Dyspnea / Q000209:etiology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications / Q000628:therapy*; D010166:Palliative Care; D019452:Terminally Ill