Reuben and Mor investigated dyspnea in 1754 terminally ill cancer patients during their last six weeks of life (National Hospice Study). Seventy percent of these patients had dyspnea, and 28 percent rated their symptom severity as “moderate or worse.” In addition to lung or pleural involvement by the tumor, the presence of underlying lung or cardiac disease and low Karnofsky performance status were significantly associated with dyspnea, whereas age and sex did not show a relationship. The authors concluded that dyspnea is much more common in terminally ill cancer patients than previously recognized. Similar to pain, the patient perceives this symptom as an indication of advancing tumor growth and this can evoke considerable anxiety. buy cipro
Dyspnea in lung cancer patients is often associated with severe fatigue, impaired cognitive function, and poor appetite, all of which can promote the patients social withdrawal. Skilled professional intervention is necessary to modify the patients response to his physical symptoms, emotions, and social environment. Ad hoc interventions are used by most clinicians in dealing with this problem. Some supportive techniques by nurses have been described; however, systematic investigation of the psychosocial management of dyspnea could aid clinical practice.