Can a Behavioral Intervention Alleviate Dyspnea in Patients With Advanced Lung Cancer?

A nurse-led behavioral intervention may help address dyspnea in patients with advanced lung cancer, according to study findings published in the Journal of Clinical Oncology.

In the study, conducted by researchers from Massachusetts General Hospital, Dana-Farber Cancer Institute, and Brigham and Women’s Hospital in Boston, Massachusetts, nearly 250 patients with advanced non-small cell lung cancer (NSCLC) were randomly selected to receive either usual care or the intervention.

Usual care consisted of what a clinician deemed appropriate, whereas the intervention included psychoeducation, relaxation training for reducing physiological stress, and behavioral techniques for managing acute breathlessness. The intervention was conducted over 2 sessions during outpatient appointments by oncology nurses who were trained by a licensed clinical psychologist.

“In patients with lung cancer, dyspnea is one of the most prevalent and disabling symptoms, for which effective treatments are lacking,” the researchers said.

The patient population included mostly those with advanced NSCLC (85.4%) who were a mean age of 66.1 years. More than half (55.9%) of the patients were women.

To determine the intervention’s effectiveness, the researchers had patients complete 5 measures at baseline and weeks 8, 16, and 24. The measures included the Modified Medical Research Council Dyspnea Scale (mMRCDS), Cancer Dyspnoea Scale (CDS), Functional Assessment of Cancer Therapy-Lung Scale (FACT-L), Hospital Anxiety and Depression Scale, and Godin-Shephard Leisure Time Physical Activity Questionnaire.

Compared with usual care, the intervention improved the primary outcome of patient-reported dyspnea on the mMRCDS (difference = –.33) at 8 weeks. However, the CDS total score was not improved by the intervention.

The CDS sense of discomfort subscale showed that patients who received intervention reported less dyspnea than those who received usual care (difference = –.59). Furthermore, the intervention group reported better functional well-being per the FACT-L versus the control group.

At 8 weeks and 24 weeks, there was no difference in overall quality of life, psychological symptoms, or activity level between both groups.

The researchers determined that behavioral intervention led by trained oncology nurses was an effective strategy to mitigate dyspnea. To determine the effects over the long-term, they feel further research is needed.

Source: Journal of Clinical Oncology