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Relationship between dyspnoea and related factors in patients with cancer: a cross-sectional study
  1. Yoshinobu Matsuda1,
  2. Hideaki Hasuo2,
  3. Keiichi Narita3,
  4. Hiromichi Matsuoka4,
  5. Ryo Morita5,
  6. Daisuke Kiuchi6,
  7. Tomoo Ikari7,
  8. Tetsuo Hori8,
  9. Koya Okazaki9,
  10. Kiyohiro Sakai10,
  11. Sayo Aiki11,
  12. Hiroko Okabayashi12,
  13. Shunsuke Oyamada13,
  14. Keisuke Ariyoshi13,
  15. Akihiro Tokoro1 and
  16. Mikihiko Fukunaga2
  1. 1Department of Psychosomatic Internal Medicine, National Hospital Organization Kinki-Chuo Chest Medical Center, Sakai, Japan
  2. 2Department of Psychosomatic Medicine, Kansai Medical University, Hirakata, Japan
  3. 3Graduate School of Medicine, Kyoto University, Kyoto, Japan
  4. 4Department of Psycho-Oncology, National Cancer Center Hospital, Tokyo, Japan
  5. 5Department of Respiratory Medicine, Akita Kosei Medical Center, Akita, Japan
  6. 6Department of Palliative Medicine, National Cancer Center Hospital, Tokyo, Japan
  7. 7Department of Palliative Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
  8. 8Department of Clinical Oncology and Palliative Medicine, Mitsubishi Kyoto Hospital, Kyoto, Japan
  9. 9Department of Respiratory Medicine, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan
  10. 10Department of Psychosomatic Medicine, Kindai University Faculty of Medicine Hospital, Osakasayama, Japan
  11. 11Department of Palliative Care, National Hospital Organization Osaka National Hospital, Osaka, Japan
  12. 12Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, Yokohama, Japan
  13. 13JORTC Data Centre, NPO, Tokyo, Japan
  1. Correspondence to Dr Yoshinobu Matsuda, Department of Psychosomatic Internal Medicine, National Hospital Organization Kinki-Chuo Chest Medical Center, Sakai 591-8555, Japan; matsuda.yoshinobu.tx{at}mail.hosp.go.jp

Abstract

Objectives Dyspnoea is a common and distressing symptom in patients with cancer. We aimed to analyse the association between dyspnoea and related factors and to estimate their causal relationship.

Methods A cross-sectional study was conducted. Patients with cancer with dyspnoea and a mean Numerical Rating Scale (NRS) of ≥3 over 24 hours were enrolled at 10 institutions in Japan from December 2019 to February 2021. The outcomes included dyspnoea, cough and pain NRS over 24 hours, Eastern Cooperative Oncology Group Performance Status, Hospital Anxiety and Depression Scale, Somatosensory Amplification Scale, opioids for dyspnoea and respiratory failure. Path analyses were conducted to estimate the direct and indirect paths with reference to dyspnoea and related factors.

Results A total of 209 patients were enrolled and 208 patients were included in the analysis. Cough worsened dyspnoea (β=0.136), dyspnoea increased emotional distress (β=1.104), emotional distress increased somatosensory amplification (β=0.249) and somatosensory amplification worsened cough (β=0.053) according to path analysis.

Conclusion There may be a vicious circle among dyspnoea and related factors: cough worsened dyspnoea, dyspnoea increased emotional distress, emotional distress increased somatosensory amplification and somatosensory amplification worsened cough. When treating dyspnoea in patients with cancer, managing these factors aimed at interrupting this vicious circle may be useful.

Trial registration number UMIN Clinical Trials Registry (UMIN000038820).

  • Dyspnoea
  • Cancer
  • Depression

Data availability statement

No data are available.

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Data availability statement

No data are available.

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Footnotes

  • Contributors YM, HH, KN, HM, SO and MF conceptualised, planned, constructed and conducted the study. YM, HH, HM, RM, DK, TI, KO, KS, SA, HO and AT enrolled patients. KA conducted data management. YM, HH, KN, HM and SO led the data analysis. YM, HH, KN, HM, SO and MF were involved in data interpretation. YM drafted the manuscript. All authors reviewed the manuscript and approved the final version. YM is guarantor.

  • Funding This study was supported by the Grant for Research Advancement on Palliative Medicine from the Japanese Society for Palliative Medicine (grant number 193).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.