Management of breathlessness in patients with cancer: ESMO Clinical Practice Guidelines

Abstract

### Highlights Breathlessness, dyspnoea and shortness of breath are synonymous terms to describe the ‘subjective experience of breathing discomfort that consists of qualitatively distinct sensations that vary in intensity’.1 2 Chronic breathlessness syndrome was recently defined by an international consensus as breathlessness ‘that persists despite optimum treatment for the underlying pathophysiology and causes disability’.3 4 The pathophysiology and characterisation of breathlessness are described in further details in the supplemental material available at ESMO Open online. Breathlessness is often cited as the most distressing symptom experienced by patients with cancer.5 A 2019 systematic review highlighted six major areas of concerns for patients living with breathlessness refractory to disease-modifying treatments, including physical, emotional, spiritual, social, control and context, unifying these under the concept of total breathlessness.6 In addition to the significant functional limitation, breathlessness can have devastating effects on patients’ quality of life (QoL) and is associated with a poor prognosis.7 ### Supplementary data [esmoopen-2020-001038supp001.pdf] This ESMO Clinical Practice Guideline provides an up-to-date, evidence-based approach on the assessment and management of breathlessness in patients with cancer (figure 1). Proper assessment of breathlessness involves screening and in-depth evaluation to characterise the symptom and direct management. Treatments include interventions aimed at reversing any underlying causes, non-pharmacological and pharmacological therapies to palliate breathlessness, and multimodal approaches. Although the focus …