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Chronic Refractory Breathlessness in Lung Cancer: Characteristics and Symptomatic Management

David C Currow, BMed, MPH, FRACP1,2, Tim HM To, BM, BS, FRACP1,2, and Amy P Abernethy, MD1,2,3

Breathlessness is the subjective experience of not being able to breathe [1]. As the sum of peripheral input (e.g. hypoxemia, excess carbon dioxide levels, and bronchoconstriction), the central drive to breathe in response to that input, and higher-level cognitive modulation, breathlessness has many facets that can either exacerbate the experience or be treated in order to relieve it [2]. The mechanism that perpetuates the experience of breathlessness is often characterized as a mismatch between peripheral stimuli that signal the need to breathe faster, and the inability of the body to respond sufficiently to the central drive to breathe more quickly [3,4]. Higher-level cognitive modulation includes factors such as anxiety and other psychological stimuli.

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