Self-Management Intervention for Breathlessness in Lung Cancer

A Pilot Trial of a Self-Management Intervention for Breathlessness in Lung Cancer

The purpose of this study is to investigate the suitability and practicality of a coaching and support intervention in helping patients to use daily strategies for managing breathlessness. Also, the investigators will try to understand how useful it is in helping patients to reduce intensity of breathlessness and its impact their quality of life.

Lung cancer is common worldwide and is a leading cause of death. Breathlessness (dyspnea or shortness of breath) is a highly prevalent clinical problem in lung cancer, developing early in 25-50% of patients due to advanced stage at presentation. It persists in 60% of survivors' post-lung resection and worsens with progressive disease with rates as high as 90% reported in the final months of life. Breathlessness is associated with a high degree of unpleasantness, negatively impacts on daily functioning, and multiple domains of quality of life, triggers fear and anxiety in patients and their family, and contributes to symptom specific and psychological distress. It is also costly to the health system as it contributes to urgent care use and hospitalization. The purpose of this pilot trial is to evaluate feasibility and acceptability of a self-management intervention for breathlessness in lung cancer.

Inclusion criteria:

Eligible participants are women and men with lung cancer (stage I to IV) receiving chemotherapy and/or radiotherapy

1. Report breathlessness occurrence (any score >=3) on a Numerical Rating Scale (0-no breathlessness; 10 - worst breathlessness) during standardized routine distress screening and/or report breathlessness as a symptom to their health care provider
2. Normal cognitive function as measured by a score of <20 on the Short Orientation Memory Cognitive Test (SOMC)
3. ECOG performance score of 0 to 2
4. Estimated life expectancy of >3 months as per physician
5. Reside within a 45 kilometre driving radius of Princess Margaret Hospital
6. Oxygen saturation >90% at rest on room air or with oxygen
7. Available for 8 consecutive weeks of the study.

Exclusion criteria:

1. Patients who have received surgery alone as the primary treatment for lung cancer
2. Unstable acute asthma or left heart failure or coronary artery or valvular heart disease or neuromuscular disease
3. Inability to comply with the study protocol including completion of the questionnaires in English
4. Major psychiatric disorder identified by the physician.