Distress with Breathing in People with Lung Cancer: A Systematic Review

Abstract

While the prevalence of shortness of breath has been reported to be as frequent as pain in people with lung cancer, less attention has been paid to the distress associated with this symptom (dyspnea). This systematic review of the literature was undertaken to investigate how this symptom has been assessed and whether breathlessness in people with lung cancer is distressing. Using a pre-determined search strategy and inclusion criteria, thirty-one primary studies were identified and included in this review. A variety of outcome measures have been used to assess the experience of dyspnea with domains including intensity, distress, quality of life, qualitative sensation and prevalence. The distress associated with breathlessness appears to be variable, with some studies reporting it to be the most distressing sensation, while others report lower levels of distress. Overall the studies reflect a high prevalence of dyspnea in lung cancer patients, with subjects experiencing a moderate level of dyspnea intensity and interference with activities of daily living. Overall, the findings of this review indicate that dyspnea was a common symptom experienced by people with lung cancer with varying degrees of intensity and unpleasantness. Thus, if dyspnea and pain are both distressing sensations for people with lung cancer, this has potential implications for both clinical and academic areas, with regards to both management strategies and further research.