Dyspnoea in advanced malignancies: a palliative care approach.

The incidence of dyspnoea in advanced malignancies varies from 48-78.6% in different studies. A systematic approach enables the clinician to separate non-malignant causes from those due to complications of malignancy. Specific treatment should be considered for airway obstruction, secondary chest infection, pleural effusions and superior vena cava obstruction. Morphine remains the most effective drug and may be delivered either orally or by inhalation. Nebulised anaesthetics are alternatives, while the value of other drugs is uncertain. Oxygen therapy and treatment of anxiety are important components.