Thank you for your kind introduction, Dr. Kubota.
I’m Dr. Tanaka, a palliative physician.
I’d like to thank Dr. Asamura for kindly inviting me to speak here today.
It is my great honor to be here with you all today and to have a chance to talk about palliative management of dyspnea.
I have no conflict of interest.
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Before I start, let me ask you a question.
Why dyspnea? Why do we have to tackle dyspnea?
Because dyspnea is one of the most frequent and refractory symptoms in lung cancer patients.
Because dyspnea interferes ‘will to live’ in terminal cancer patients.
Therefore, the appropriate understanding, assessment and palliation of dyspnea is important to improve QOL of cancer patients and also their family members.
And it may possibly
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Visual analogue scale and face scale are other options.
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How do we assess the qualities, in other words, the character of dyspnea?
Ask the patients, ‘how do you feel?’
The Cancer Dyspnea Scale is the validated scale for assessing the multidimensional nature of dyspnea.
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How do we assess the impact of dyspnea?
Ask the patient, ‘what does dyspnea interfere with your daily life?’
MD Anderson symptom inventory is the scale, assessing how much and how frequently dyspnea interfere with physical and psychological activities.
To summarize so far, believe patients’ self-assessment.
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Now, let’s move into the management.
The goal of dyspnea management is to reduce its frequency and severity, minimize its physical, psychological and spiritual distress, and maximize patients' function and QOL.
How?
At first, we have to identify all the underlying causes, and treat them with specific modalities accordingly.
It is, therefore, important for oncologists to judge treatability and adverse effects, and estimated prognosis accurately.
This session will focus on symptomatic and pharmacological treatment, with introducing our guidelines.