Episodic Dyspnea in Patients With Advanced Lung Cancer: International Update
Posted: Friday, October 22, 2021
Investigators documenting the frequency of episodic dyspnea in nonhospitalized adults with advanced (stage III or IV) lung cancer also sought to learn what treatments, both pharmacologic and nonpharmacologic, might ease their pain and shortness of breath. They found that patients with intrathoracic comorbidities, cachexia, or on supportive care tended to report episodic dyspnea more frequently than others. Josep Porta-Sales, MD, PhD, of Hospital Universitario La Paz, Madrid, and colleagues discussed these findings and more on this condition in a presentation during the 13th World Congress of the European Association for Palliative Care (Abstract B-18), which was also simultaneously published in Palliative Medicine.
Of 366 individuals making consecutive outpatient visits for palliative care or oncology treatment to 10 different hospitals in Spain, about one-third (n = 117) reported having episodic dyspnea, and about two-thirds (n = 249) reported they did not. In addition, about half (n = 59) of those with reported episodic dyspnea were prescribed opioids, and fentanyl was the most frequently prescribed drug in that class, followed by morphine. The most commonly utilized nonpharmacologic treatments were rest, physiotherapy, and oxygen; of note, these modalities “seemed to [work] faster [than pharmaceuticals] in treating the episode,” said the authors.
Of the 117 patients with episodic dyspnea, 79 (67.5%) were prescribed one or more pharmacologic treatments, including inhaled bronchodilators (n = 55; 47.1%) and oral steroids (n = 47; 40.2%) as well as opioids, whereas 86 (84.6%) utilized nonpharmacologic methods. The mean age of the full patient cohort was 65 years, and 67.5% were men.
Patients with advanced lung cancer with certain intrathoracic comorbidities (chronic obstructive pulmonary disease, vapor pressure deficit, heart failure) or cachexia, or who received supportive care, were more likely to report episodic dyspnea. However, the researchers noted, “specific symptomatic pharmacological treatment for [the condition]…was seldom used. Overall, its treatment is “largely variable.”
Disclosure: The study authors reported no conflicts of interest.
