Cancer: the more they breathe, the sooner they die

Respiratory rate (breathing frequency) of cancer patients is an independent predictor of their survival (Chiang et al, 2009; de Miguel Sanchez et al, 2006; Groeger et al, 1998). Those, who breathe more frequently, has poor prognosis.

Last year the Journal of Applied Physiology published a study done in the Department of Medicine, Queen’s University (Kingston, Ontario, Canada). It was found that 40 patients with cancer breathed about 12 litres of air per minute at rest (Travers et al, 2008), instead of 6 l/min, which is the medical norm.  Breathing frequency of these cancer patients was 20 breaths per minute (the norm is only 12 breaths per min at rest).

What else is known about respiratory parameters of cancer patients at rest? Just a few titles and some quotes are sufficient to realize what is going on with breathing of terminally ill cancer patients.

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Reuben DB, Mor V, Dyspnea in terminally ill cancer patients, Chest 1986; 89: p. 234–236.

Dudgeon DJ, Lertzman M, Dyspnea in the advanced cancer patient, J Pain Symptom Management 1998 Oct; 16(4): p.212-219.

Coyne PJ, Viswanathan R, Smith TJ, Nebulized fentanyl citrate improves patients’ perception of breathing, respiratory rate, and oxygen saturation in dyspnea, J Pain Symptom Manage 2002; 23: p. 157–160.

“Dyspnea is exceedingly common. Ruben and Mor found that 70% of 1500 cancer patients suffered dyspnea during their last four weeks of life.”

Bruera E, MacEachern T, Ripamonti C, Hanson J, Subcutaneous morphine for dyspnea in cancer patients, Ann Intern Med. 1993; 119: p. 906-907.

Travers J, Dudgeon DJ, Amjadi K, McBride I, Dillon K, Laveneziana P, Ofir D, Webb KA, O’Donnell DE, Mechanisms of exertional dyspnea in patients with cancer, J Appl Physiol 2008 Jan; 104(1): p.57-66.

Reuben DB, Mor V, How much of a problem is dyspnoea in advanced cancer? Palliat Med 1991; 5: 20–26.

“Introduction. Although a number of articles on dyspnoea in terminal cancer have appeared, [1-8] in terms of publications, this symptom remains a poor relation when compared with pain. Anyone, however, who has looked after dying people will be aware that dyspnoea is a common and often distressing symptom, particularly if severe. In such cases patients may feel that they may die from lack of air – even pain does not have this connotation. This is demonstrated in Comroe’s definition of dyspnoea as ’difficult, laboured, uncomfortable breathing; it is an unpleasant type of breathing, though it is not painful in the usual sense of the word. It is subjective, and, like pain, it involves both perception of the sensation by the patient and his reaction to the sensation.”

Ripamonti C. Management of dyspnea in advanced cancer patients. Support Care Cancer. 1999; 7: p. 233-243.

“Dyspnea has been defined as an “uncomfortable awareness of breathing””

(End of quotes.)

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But normal breathing is invisible, inaudible, and imperceptible, because it is tiny in tidal volume and very slow in frequency. Moreover, according to physiological laws, normal breathing provides humans with superior tissue oxygenation. Hence, healthy people do not feel their breath at all. These cancer patients breathe at least 3-4 times more than the norm in order to be uncomfortably aware about their breathing. fenbendazole cancer treatment