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Review
. 2021 Jul 2;10(4):LMT52.
doi: 10.2217/lmt-2020-0017. eCollection 2021 Dec.

Enabling patients in effective self-management of breathlessness in lung cancer: the neglected pillar of personalized medicine

Doris Howell  1   2
Affiliations
Review

Enabling patients in effective self-management of breathlessness in lung cancer: the neglected pillar of personalized medicine

Doris Howell. Lung Cancer Manag. .

Abstract

Globally, engagement of patients in the self management of disease and symptom problems has become a health policy priority to improve health outcomes in cancer. Unfortunately, little attention has been focused on the provision of self-management support (SMS)in cancer and specifically for complex cancer symptoms such as breathlessness. Current management of breathlessness, which includes treatment of underlying disease, pharmacological agents to address comorbidities and opiates and anxiolytics to change perception and reduce the sense of breathing effort, is inadequate. In this perspective paper, we review the rationale and evidence for a structured, multicomponent SMS program in breathlessness including four components: breathing retraining, enhancing positive coping skills, optimizing exertional capacity and reducing symptom burden and health risks. The integration of SMS in routine lung cancer care is essential to improve breathlessness, reduce psychological distress, suffering and improve quality of life.

Keywords: breathlessness; lung cancer; perspective; self-management.

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Conflict of interest statement

Financial & competing interests disclosure The author has no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties. No writing assistance was utilized in the production of this manuscript.

Figures

Figure 1.
Figure 1.. Mechanistic targets for SMS programs for breathlessness and outcomes for measurement of effectiveness.
SMS: Self-management support.
Figure 2.
Figure 2.. Core components of self-management programs for breathlessness in lung cancer.
COPD: Chronic obstructive pulmonary disease.
Figure 3.
Figure 3.. Adapted 5As for counseling in behavior change for breathlessness self-management.
See this image and copyright information in PMC

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