Palliative Care – Shortness of Breath

Palliative Care – Shortness of Breath

How to manage shortness of breath (dyspnoea)


Shortness of breath is a symptom common to lung cancers, cardiac failure, end stage renal disease, advanced neurological disease and chronic obstructive airways disease. It starts to appear in in the terminal stages of other cancers too in up to 90% of cases.

Shortness of breath is not just affected by bio-physical problems but by social, psychological and spiritual factors too. In fact, similar brain pathways that are involved with chronic pain are involved with dyspnoea too. As a result of this, it is important to look for other factors that could be worsening (and which improve) shortness of breath other than medical factors.

Research is showing that very low dosages of morphine can be an effective treatment for shortness of breath in patients with both cancer and chronic obstructive airways disease.  But there are other non-pharmacological strategies that are as equally important. A great pneumonic to remember these is, BREATHE. This stands for:

Breathing retraining

Relaxation techniques

Energy expenditure modification (learning to pace yourself, plan your week and prioritise what is important)

Anxiety management

Tools: dyspnoea management scales and patient education diaries

Help or hinder (what things make your shortness of breath worse and what makes it better)

Emergency plan


Knowing how to manage your shortness of breath will help decrease visits to the emergency room and give you more control over your illness.