Positive expiratory pressure involves breathing against an airway resistance provided by a flute-like device. This approach has been used for lung training and to open and clear airways. This intervention, along with patient self-monitoring of forced expiratory volume in 1 second (FEV1), was evaluated for its effect on the development of pneumonia in high-risk patients with cancer. FEV1 monitoring was used for early detection of pulmonary deterioration, enabling early diagnostic testing and interventions as needed.