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Fan-blown air is one of several drug-free treatments that may ease breathlessness in advanced cancer patients.
Researchers also found that medications -- including opioid painkillers -- do little to help.
"Breathlessness, or dyspnea, is a common and distressing symptom in patients with advanced cancer," said lead author Dr. Arjun Gupta. He's chief medical oncology fellow at Johns Hopkins Kimmel Cancer Center in Baltimore.
The non-drug interventions that helped hospitalized patients with breathlessness included fan therapy (air blown by a fan into the patient's face) and bilevel ventilation (air pressure delivered through a face mask covering the mouth and nose). Both brought relief lasting from a few minutes to a few hours.
For outpatients, drug-free methods such as acupressure and reflexology, as well as a combination of activity and rehabilitation with behavioral, psychosocial and integrative medicine, provided relief lasting for a few weeks to months, the study found.
The drug-free approaches posed minimal risks, according to the study, recently published in the journal JAMA Oncology.
In a companion report published by the U.S. Agency for Healthcare Research and Quality, the same team analyzed 50 studies and found that opioids and anti-anxiety drugs were no more effective than placebo for improving breathlessness.
Medications can also cause side effects such as drowsiness and constipation, the researchers noted.
"Traditionally, in the ward, medications such as opioids and benzodiazepines are often used to treat breathlessness," Gupta said in a Hopkins news release.
But these findings suggest the need for "a shift in how we approach and treat breathlessness, away from a medicalized approach using drugs, to a more comprehensive assessment and attempting nonpharmacologic interventions, such as fan therapy, first," he said.
"Clinical guidelines and practice should evolve to represent these novel findings," Gupta added.
SOURCE: Johns Hopkins Medicine, news release, Dec. 10, 2020
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