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Cancer – Breathlessness – Positive/Negative Cycles

If you notice a sudden increase in breathlessness, ask your specialist oncologist or a GP.

Breathlessness can be a distressing symptom experienced by many patients, either as a direct result of disease or treatment and frequently compounded by de-conditioning.

Evidence shows that aerobic exercise can improve cardiopulmonary function during cancer treatment. Prior to surgery, improvement in cardiorespiratory fitness in lung cancer patients is linked to positive changes in clinical outcomes and to functional walking capacity, with patients in the active arms of trial groups also spending less time in hospital, with lower complication rates.

Disease related features such as lung primary or secondary, anaemia, muscle loss, fatigue and reduced lung function can all compound symptoms, as can treatment-related surgery, radiotherapy. Patients experiencing breathlessness may be disinclined to exercise due to heightened perceptions of breathing discomfort and concerns that physical activities will worsen their symptoms. Eliciting concerns, information about the benefits of physical activity and individualised advice on how to begin and pace activity can be useful approaches.

References

Cavalheri V1, Granger C, Preoperative exercise training for patients with non-small cell lung cancer, Cochrane Database Syst Rev. 2017 Jun 7;6:CD012020. doi: 10.1002/14651858.CD012020.pub2.

Driessen EJ, Peeters ME, Bongers BC, Janssen-Heijnen ML, et al.,Effects of prehabilitation and rehabilitation including a home-based component on physical fitness, adherence, treatment tolerance, and recovery in patients with non-small cell lung cancer: A systematic review, Crit Rev Oncol Hematol. 2017 Jun;114:63-76.

Singh F, Newton RU, Galvão DA, Spry N, Baker MK, A systematic review of pre-surgical exercise intervention studies with cancer patients, Surg Oncol. 2013 Jun;22(2):92-104.