Fentanyl for episodic dyspnoea in cancer patients

Dyspnoea or breathlessness is defined by the American Thoracic Society as ‘‘a subjective experience of breathing discomfort that consists of qualitatively distinct sensations that vary in intensity’’ (1). It is highly prevalent in patients with lung cancer, heart failure and chronic obstructive pulmonary disease, three of the most common illness worldwide. Patients with life-limiting cardio-respiratory illnesses have higher intensity of breathlessness for the last three months of life than patients with primary and secondary lung cancer, but breathlessness severity increases in both groups of patients on the last weeks of the life (2,3). Thus, prevalence and severity of dyspnoea escalate significantly as death approaches regardless of underlying life-limiting diseases