• Viola R, Kiteley C, Lloyd N, Mackay JA, Wilson J, Wong R, Supportive Care Guidelines Group. The management of dyspnea in cancer patients: a clinical practice guideline. Toronto (ON): Cancer Care Ontario (CCO); 2006 Nov 6. 46 p. (Evidence-based series; no. 13-5). [64 references]

Opioids

• Systemic opioids, by the oral or parenteral routes, can be used to manage dyspnea in advanced cancer patients.
• Nebulized morphine should not be used to treat dyspnea.

Phenothiazines, Benzodiazepines, and Systemic Corticosteroids

• Oral promethazine may be used to manage dyspnea, as a second-line agent if systemic opioids cannot be used or in addition to systemic opioids. Promethazine must not be used parenterally.
• Prochlorperazine is not recommended as a therapy for managing dyspnea.
• No comparative trials are available to support or refute the use of other phenothiazines, such as chlorpromazine and methotrimeprazine, for managing dyspnea.
• Benzodiazepines are not recommended for managing dyspnea.
• No comparative trials are available to support or refute the use of systemic corticosteroids for managing dyspnea in advanced cancer patients.

None provided

The recommendations are supported by evidence-based practice guidelines, systematic reviews, randomized controlled trials (RCTs), two abstracts of RCTs, and three fully published non-randomized trials.

• Viola R, Kiteley C, Lloyd N, Mackay JA, Wilson J, Wong R, Supportive Care Guidelines Group. The management of dyspnea in cancer patients: a clinical practice guideline. Toronto (ON): Cancer Care Ontario (CCO); 2006 Nov 6. 46 p. (Evidence-based series; no. 13-5). [64 references]

Not applicable: The guideline was not adapted from another source.

2006 Nov

Program in Evidence-based Care - State/Local Government Agency [Non-U.S.]

The Program in Evidence-based Care (PEBC) is a Province of Ontario initiative sponsored by Cancer Care Ontario and the Ontario Ministry of Health and Long-Term Care.

Cancer Care Ontario
Ontario Ministry of Health and Long-Term Care

Supportive Care Guidelines Group

Members of the Supportive Care Guidelines Group (SCGG) were asked to disclose any potential conflicts of interest and declared there were none.

The following is available:

• Browman GP, Levine MN, Mohide EA, Hayward RSA, Pritchard KI, Gafni A, et al. The practice guidelines development cycle: a conceptual tool for practice guidelines development and implementation. J Clin Oncol 1995;13(2):502-12.

None available

This summary was completed by ECRI Institute on April 8, 2008.