Management of Dyspnea in Advanced Cancer: ASCO Guideline

PURPOSE To provide guidance on the clinical management of dyspnea in adult patients with advanced cancer. METHODS ASCO convened an Expert Panel to review evidence and formulate recommendations. An Agency for Healthcare Research Quality (AHRQ) systematic provided base nonpharmacologic pharmacologic interventions alleviate dyspnea. The included randomized controlled trials (RCTs) observational studies a concurrent comparison group published through early May 2020. also wished address assessment, underlying conditions, palliative care referrals, these questions, additional identified RCTs, reviews, guidelines July RESULTS AHRQ 48 RCTs two retrospective cohort studies. Lung cancer mesothelioma were most commonly addressed types Nonpharmacologic such as fans some relief from breathlessness. Support was limited. A meta-analysis specialty breathlessness services reported improvements distress because RECOMMENDATIONS hierarchical approach is recommended, beginning ascertainment potentially reversible causes, referral interdisciplinary team. that may be offered relieve include airflow (eg, fan directed at cheek), standard supplemental oxygen hypoxemia, other psychoeducational, self-management, or complementary approaches. For who derive inadequate interventions, systemic opioids should offered. Other corticosteroids benzodiazepines, are discussed. Additional information available www.asco.org/supportive-care-guidelines .