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Recent Advances in the Palliative Management of Respiratory Symptoms in Advanced-Stage Oncology Patients

Division of Pulmonary Medicine and Critical Care, Jefferson Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania, andrew.haas{at}jefferson.edu

Advanced-stage malignancies are often characterized by systemic complications related to primary tumor progression. Pulmonary complications such as cough and dyspnea are relatively common and can dramatically reduce quality of life and lead to inpatient or intensive care unit admission. Although cancer-induced cough can be improved with radiation therapy or chemotherapy, or both, it is often best managed with central-acting opioids. Dyspnea can arise from a range of etiologies that may or may not be related to the underlying malignant pulmonary disease. Recent advances in the management of malignant pleural effusion, central airway obstruction, and superior vena cava syndrome have allowed relatively noninvasive interventions to be performed that can significantly reduce dyspnea, minimize inpatient hospitalization, and improve the quality of life in patients where the major focus is palliative care.

Key Words: pneumonia • malignant pleural effusion • central airway obstruction • superior vena cava

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