The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.

Overview

Added text on dyspnea and its optimal treatment.

Dyspnea and Coughing in Patients With Advanced Cancer

Added lymphangitic carcinomatosis, pericardial effusion, paralysis of a hemidiaphragm, anemia, certain acidotic states, bronchospasm, and functional causes (e.g., anxiety) as direct causes of dyspnea.

Revised text to state that assessment of dyspnea should also include appreciation of the dynamic component of dyspnea—namely, exertional dyspnea.

Added superior venal caval obstruction, pericardial effusions, and pulmonary embolism as examples of underlying causes of dyspnea.

Revised text to state that symptomatic management of dyspnea is based primarily on oxygen therapy, opioids for palliation of dyspnea, and treatment of underlying causes (e.g., superimposed infection) when appropriate.

Malignant Pleural Effusion

Added text to state that the choice of treatment depends on patient prognosis, functional status, and goals of care.

Added text to state that tunneled pleural catheters allow up to 96% of patients to achieve symptom improvement, with spontaneous pleurodesis occurring on its own in up to 44% of patients (cited Tremblay et al. as reference 7).

Added text to state that reaccumulation rate is approximately 98% by day 30 (cited Anderson et al. as reference 8).

Malignant Pericardial Effusion

Revised text to state that catheter drainage is recommended for large effusions for the anticipated survival of the patient.

Added text to state that consideration must be given to the side effects of various sclerosing agents, e.g., chest pain and arrhythmias.

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