Dyspnea with Advanced Cancers

This information is useful for children, adults, and older adults
A woman suffering with dypnea struggling to breath.

Dyspnea is the medical term that describes shortness of breath. It is a complex symptom that’s experienced by people in many different ways. Some people describe the uncomfortable sensation as not being able to breathe fast or deeply enough. Some say it feels like they are running out of air even while resting, while others report the sensation of urgently needing to inhale again, even before an exhalation is complete. Some people even describe dyspnea as “tightness” in the chest, which creates the feeling of constriction and physical inability to draw a breath. And still others describe their dyspnea as a physical tiredness when breathing. This feeling of starving for oxygen is also known as “air hunger.”

More than 50 percent of people with advanced stage cancer, and between 50 and 75 percent of people with lung cancer, experience dyspnea. It becomes more common in the final six weeks of life for people with advanced stage cancer. One of the most distressing symptoms of advanced cancer, dyspnea has physical, psychological, social, and spiritual implications.  

Not a lot is known about the underlying causes of dyspnea. When a cause can be identified, doctors do all they can to treat it (for instance, removing fluid that has built up around the lungs) in order to alleviate its symptoms. Other treatment options can include respiratory care and drugs including opioids, benzodiazepines, and steroids. 

“In the end, doctors look for reversible causes to treat first. If symptoms persist or there isn’t a reversible cause, doctors use both drug therapy and non-pharmacologic therapies like oxygen, Reiki, and guided imagery,” says Laura Morrison, MD, a Yale Medicine palliative care doctor who is part of the Palliative Care Program at Smilow Cancer Hospital. Most people with dyspnea can find relief with this systematic approach to care.

“Most people don’t realize that being able to feel airflow, whether with oxygen or room air flowing through a nasal cannula in the nose or with a fan blowing on one’s face, is therapeutic in itself,” she says. “Studies have shown this airflow alone creates signals to the brain that can help one feel less short of breath.”