Shortness of breath and other respiratory symptoms frequently complicate the symptomatic management of terminally ill adults. The extent of the problem in children is not known, but anecdotal evidence from nurses and physicians experienced in paediatric oncology has suggested that respiratory problems are less frequent in children dying from malignant disease than in adults. This is a retrospective review of all children dying from cancer under the care of the symptom care team at the Royal Marsden Hospital between 1982 and 1993. The results show that respiratory symptoms were recorded during the last three months of life in 40% of analysable case histories. The nature of respiratory symptoms in paediatric cancer patients is discussed.
Coyle N., Adelhardt J., Foley K., Portenoy R.Character of terminal illness in the advanced cancer patient: pain and other symptoms during the last four weeks of life. J Pain Symptom Manage1990; 5: 83-93.
2.
Doyle D.Symptom relief in terminal illness. Med Pract1983; 27: 694-98.
3.
Bruera E.Research in symptoms other than pain. In: Doyle D, Hanks G, MacDonald N eds.Oxford textbook of palliative medicine. Oxford: Oxford University Press, 1993: 87-92.
4.
Walsh TDSymptom control in patients with advanced cancer. Am J Hosp Palliat Care1992; 9 (6): 32-40.
5.
Fainsinger R. , Miller MJ, Bruera E., Hanson J., MacEachem T.Symptom control during the last week of life on a palliative care unit. J Palliat Care1991; 7 (1): 5-11.
6.
Cowcher K., Hanks G.Long-term management of respiratory symptoms in advanced cancer. J Pain Symptom Manage1990; 5: 320-29.
7.
Reuben D., Mor M.Dyspnea in terminal cancer patients. Chest1986; 89: 234-36.
8.
Hunt AMA survey of signs, symptoms and symptom control in 30 terminally ill children . Dev Med Child Neurol1990; 32: 341-46.
9.
Davis C.The therapeutics of dyspnoea. Cancer Surv1994; 21: 85-98.
10.
Twycross R.Symptom control: the problem areas. Palliat Med1993; 7 (suppl 1): 1-8.
11.
Ahmedzai S.Palliation of respiratory symptoms. In: Doyle D, Hanks G, MacDonald N eds. Oxford textbook of palliative medicine . Oxford: Oxford University Press , 1993: 349-78.
12.
Horn LWTerminal dyspnea: a hospice approach. Am J Hosp Palliat Care1992; 9 (2): 24-32.
13.
Gong QL, Hedner T., Hedner J., Bjorkman R., Nordberg G.Antinociceptive and ventilatory effects of the morphine metabolites: morphine-6-glucuronide and morphine-3-glucuronide. Eur J Pharmacol1991; 193:47-56.
14.
Paintal ASMechanism of stimulation of type J pulmonary receptors. J Physiol (Lond)1969; 203: 511-32.
Nakayama K.The surgical significance of the carotid body in relation to bronchial asthma . J Int Coll Surg1963; 39: 374-89.
17.
Kikuchi Y., Okabe SG, Hida W., Homma M., Shirato K., Takishima T.Chemosensitivity and perception of dyspnea in patients with near-fatal asthma . N Engl J Med1994; 330: 1329-34.
18.
Bruera E., Schoeller T., MacEachern T.Symptomatic benefit of supplemental oxygen in hypoxemic patients with terminal cancer: the use of the N of 1 randomized controlled trial. J Pain Symptom Manage1992; 7: 365-68.
19.
Bruera E., de Stoutz N., Velasco LA, Schoeller T., Hanson J.Effects of oxygen on dyspnoea in hypoxaemic terminal cancer patients. Lancet1993; 342: 13-14.
20.
Kerem E., Bentur L., England S. et al. Sequential pulmonary function measurements during treatment of infantile chronic interstitial pneumonitis. J Pediatr1990; 116: 61-67.
21.
Purssell E.Physical symptom control in children who are dying. J Cancer Care1994; 3: 31-35.
22.
Enck REThe last few days. Am J Hosp Palliat Care1992; 9 (4): 11-13.
23.
Enck REDrug-induced terminal sedation for symptom control. Am J Hosp Palliat Care1991; 8 (5): 3-5.
