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  • Breathlessness, dyspnoea and shortness of breath are terms used to describe the subjective experience of breathing discomfort or difficulty

  • Breathlessness is common, affecting between 20% and 70% of patients with cancer, particularly among patients with thoracic malignancies, with advanced stages of disease, and in the last weeks of life. 

  • Breathlessness may be related to cancer progression, cancer therapies and/or acute complications such as infections or pulmonary embolism. Pre-existing comorbidities such as COPD and heart failure may also contribute to breathlessness. One of the key strategies in the management of breathlessness is to identify and treat any potential underlying cause(s)       

  • (ESMO clinical practice guideline)

Are you a health professional looking for immediate guidance? 

UKONS Acute Oncology Initial Management Guideline may help




Cancer treatment related

Cancer related


  • Cytotoxic chemotherapy-induced pulmonary toxicities

  • Malignant ascites

  • Anaemia

  • Immunotherapy-induced pulmonary toxicities

  • Malignant pleural effusion

  • Asthma/COPD

  • Radiation-induced pneumonitis or fibrosis

  • Malignant pericardial effusion/tamponade

  • Heart failure


  • Superior vena cava syndrome

  • Metabolic acidosis


  • Lymphangitic carcinomatosis

  • Pneumonia


  • Cachexia

  • Pulmonary embolism


  • Central airway obstruction



National and international guidelines

Management of Breathlessness in Patients with Cancer: ESMO Clinical Practice Guidelines. Published in 2020 – ESMO Open (2020)

 NICE Palliative care - dyspnoea. Last revised in March 2021


Dyspnea. Mechanisms, assessment, and management: a consensus statement. American Thoracic Society.nAm J Respir Crit Care Med. 1999; 159: 321-340 doi:10.1164/ajrccm.159.1.ats898 

Parshall M.B. Schwartzstein R.M. Adams L. et al.

An official American thoracic Society statement: update on the mechanisms, assessment, and management of dyspnea. Am J Respir Crit Care Med. 2012; 185: 435-452 doi:10.1164/rccm.201111-2042ST


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