Management of dyspnea in older adults with cancer

Amy P. Abernethy, Jane L. Wheeler, David C. Currow

    Research output: Chapter in Book/Report/Conference proceedingChapterpeer-review


    Dyspnea, a complex psychophysiologic phenomenon characterized by the sensation of breathlessness, afflicts a substantial proportion of advanced cancer patients. Reported prevalences range from 15 to 79 percent, depending on the primary tumor site and other factors. A prospective study of 1,860 adult patients with advanced cancer found an overall prevalence of 19 percent, with highest prevalence (46%) among lung cancer patients and lowest (6%) among head and neck cancer patients. Another prospective study in a general cancer population (n = 923) reported an overall dyspnea prevalence of 46 percent. Among a general population in the community (n = 8,396), the prevalence of substantial breathlessness that limits exertion is 9 percent. Among terminally ill cancer patients, a retrospective analysis of National Hospice Study data found that prevalence rates generally exceeded 50 percent. For elderly cancer patients, dyspnea can be especially troubling. In a Finnish study of consecutive cancer patients with heterogeneous diagnoses (n = 203, mean age 65 years), dyspnea ranked among the four most disturbing symptoms as reported by patients on the Edmonton Symptom Assessment System, ranking symptoms on a scale of 0–10. Forty-nine percent of total respondents reported experiencing dyspnea; 18 percent reported a dyspnea score of 4 or greater. A Taiwanese study of symptom patterns of advanced cancer patients in a palliative care unit (n = 77, mean age 62 years) found that dyspnea was experienced by 49 percent of patients on admission, 42 percent 1 week after admission, and 67 percent 2 days before death; of 19 symptoms monitored, only dyspnea and anorexia exhibited a pattern of decrease then increase.

    Original languageEnglish
    Title of host publicationPractical Geriatric Oncology
    EditorsArti Hurria, Harvey Jay Cohen
    Place of PublicationCambridge University Press
    PublisherCambridge University Press
    Number of pages14
    ISBN (Electronic)9780511763182
    ISBN (Print)9780521513197
    Publication statusPublished - 1 Jan 2010


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