Dyspnea is a subjective experience of difficult breathing or sensation of breathlessness that can occur rapidly and lead to a feeling of impending doom. Dyspnea can be common in patients with primary or metastatic lung or pleural involvement; however, patients with cancer without direct involvement of these areas also report it. Prevalence of dyspnea has been reported to be highest in patients with lung, breast, and esophageal cancer. Dyspnea has been estimated to occur in 15%–55% of patients at the time of cancer diagnosis and as many as 70% of patients with terminal cancer. Dyspnea in patients with cancer may be caused by the cancer directly or cancer treatment, or it may be unrelated to the cancer or associated with other underlying medical conditions. It is important for healthcare professionals to assess and treat any underlying causes of dyspnea, if known.

Immune-Related Adverse Events With Immunotherapy

Although not common, pneumonitis has been reported in patients receiving immunotherapies. Symptoms such as dyspnea or cough may indicate pneumonitis. Prompt diagnosis with radiographic imaging and interventions is essential. Usual treatment is the administration of systemic corticosteroids (Linardou & Gogas, 2016).

This topic was updated on August 26, 2019. Learn more about these updates.

Brahmer, J.R., Lacchetti, C., Schneider, B.J., Atkins, M.B., Brassil, K.J., Caterino, J.M., ... Hallmeyer, S. (2018). Management of immune-related adverse events in patients treated with immune checkpoint inhibitor therapy: American Society of Clinical Oncology Clinical Practice Guideline. Journal of Clinical Oncology, 36, 1714–1768. https://doi.org/10.1200/JCO.2017.77.6385

Linardou, H., & Gogas, H. (2016). Toxicity management of immunotherapy for patients with metastatic melanoma. Annals of Translational Medicine, 4, 272. https://doi.org/10.21037/atm.2016.07.10

2017–2019 Authors
Brenda K. Shelton, DNP, RN, CCRN, AOCN®, Angela Adames, BSN, RN, OCN®, Halim F. Dagher, BSN, RN, OCN®, Elisabeth Dolan, RN, MSN, NP- C, ACHPN, OCN®, Peter Miller, BSN, PHN, Lauren Oliveira, RN, BSN, Kerstin Scheper MSN, RN-BC, OCN®, CHPN, and Patty Starr, NP-BC
ONS Staff: Pamela K. Ginex, EdD, MPH, RN, OCN®Margaret M. Irwin, PhD, RN, MN, Christine M. Maloney, BA, Kerri A. Moriarty, MLS, and Mark Vrabel, MLS, AHIP, ELS
2007–2016 Authors
Angela Adames, BSN, RN, OCN®, Ann E. Culkin, RN, OCN®, Halim F. Dagher, BSN, RN, OCN®, Wendye M. DiSalvo, MSN, ARNP, AOCN®, Elisabeth Dolan, RN, MSN, NP- C, ACHPN, OCN®, Margaret M. Joyce, PhD, RN, ANP-BC, Kathleen Mackay, RN, BSN, OCN®, Peter Miller, BSN, PHN, Lauren Oliveira, RN, BSN, Kerstin Scheper RN-BC, OCN®, CHPN, Brenda K. Shelton, DNP, RN, CCRN, AOCN®, Patty Starr, NP-BC and Leslie B. Tyson, MS, APRN-BC, OCN®
ONS Staff: Heather Belansky, RN, MSN, Margaret M. Irwin, PhD, RN, MN, Lee Ann Johnson, PhD, RN, Barbara G. Lubejko, MS, RN, Christine M. Maloney, BA, Kerri A. Moriarty, MLS, and Mark Vrabel, MLS, AHIP, ELS

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