Breathing problems
Authors:
Dr. Christine Maheu, RN, PhD ,
Ms. Rosemary Cashman ,
Kyla Johnson, Occupational Therapist, Segal Cancer Centre, Jewish General Hospital ,
Ms. Maureen Parkinson, Vocational Rehabilitation Counsellor, M.Ed. C.C.R.C, BC CancerDr. Christine Maheu, RN, PhD
Dr. Christine Maheu is an Associate Professor in the Ingram School of Nursing, Faculty of Medicine, McGill University. Dr. Maheu is also an Affiliate Scientist at the University Health Network and the University of Toronto. At McGill University, she teaches research methods, supervises graduate students (masters, doctoral, post-doctoral), mentors practicing nurses and students in research, and conducts research in English and French. She has held research awards with the Canadian Institutes of Health Research, the Canadian Cancer Society, and the Canadian Partnership Against Cancer. These awards funded her research in psychosocial oncology, which focuses on developing and testing psychosocial interventions or measurements tools for various cancer populations. Additionally, in partnership with Ipsos Canada and funded by the Canadian Partnership Against Cancer, she is co-leading a nationwide survey of the needs of cancer patients for transition care from the end of their treatment to three years after their diagnosis. Dr. Maheu received awards for excellence in nursing research (2013, 2015, 2016) from Ovarian Cancer Canada, the Canadian Association of Nurses in Oncology, and the Quebec Association of Nurses in Oncology.
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Ms. Rosemary Cashman
Ms. Rosemary Cashman is a nurse practitioner at the BC Cancer Agency and an Adjunct Professor in the Faculty of Nursing at the University of British Columbia. Her professional experience includes the care of lymphoma, lung cancer and brain cancer patients. She co-chairs the Patient and Family Advisory Council, which guides the brain tumour care program at the BC Cancer Agency. She has authored book chapters and articles related to the care of brain tumour patients and their families. Ms. Cashman was involved in developing and implementing a rapid-access radiotherapy clinic for the palliative treatment of lung cancer and she continues to work in this clinic.
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Kyla Johnson, Occupational Therapist, Segal Cancer Centre, Jewish General Hospital
Ms. Kyla Johnson, M.Sc.A., originally from Edmonton, Alberta, Kyla Johnson works as an Occupational Therapist at the Segal Cancer Center of the Jewish General Hospital. She holds a Master of Science in Occupational Therapy from McGill University. Her goal as a rehabilitation professional in Oncology is to enable people with cancer to be able to do what they want and need to do, in all stages of their cancer experience. Kyla helps develop strategies and accommodations to facilitate a return to meaningful life roles, including work. She is specialized in cancer-related cognitive dysfunction and runs a weekly group teaching strategies to improve daily cognitive functioning. Kyla also leads a volunteer yoga class for young adults with cancer. She lives in Montreal, Quebec.
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Ms. Maureen Parkinson, Vocational Rehabilitation Counsellor, M.Ed. C.C.R.C, BC Cancer
Ms. Maureen Parkinson is the province-wide vocational rehabilitation counsellor at the BC Cancer Agency. She has also been vocational rehabilitation counsellor at a public rehabilitation hospital and vocational rehabilitation consultant to insurance companies and the court system. She has instructed and facilitated Service-Canada-funded programs on job searching and career exploration. Ms. Parkinson has a Masters in Counselling Psychology, is a Canadian Certified Rehabilitation Counsellor, and completed the Certified Return to Work Coordinator Program through the National Institute for Disability Management and Research. She has developed return-to-work and job-search seminars for cancer patients and created the guidebook “Cancer and Returning to Work: A Practical Guide for Cancer Patients” as well as on-line articles about returning to work and school. She also co-authored a paper commissioned by the Canadian Association of Psychosocial Oncology, “Cancer and Work: A Canadian Perspective”.
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Cancer-related breathing problems include dyspnea (difficult or laboured breathing) and breathlessness (feeling short of breath). Breathing problems affect 20%–40% of individuals diagnosed with cancer and are even more common in those with lung, breast, prostate and advanced cancer. The causes include some cancer treatments, anemia, infection, deconditioning, pre-existing lung disease and cancer itself.
Vocational implications
The extent to which breathing problems affect ability to perform a job depends on the severity of the symptoms and the job demands. Physically demanding jobs may be more challenging for those with breathing problems.
What patients can do
Talk to the patient about the cause and management of their specific breathing problems and ask your patient what situations make breathing worse or better. Treat any underlying condition when possible. Medications may be helpful in reducing the severity of symptoms. When fluid in the lungs is causing the breathing problems, the fluid may be removed. Other strategies include:
- breathing techniques, such as pursed lip and abdominal breathing
- relaxation training
- positioning the body to breathe most easily
- conserving energy
- regular exercise as tolerated
Job accommodations
There are several ways that jobs can be modified to accommodate breathing problems.
Modify work tasks and schedules:
- If the job requires a uniform, request alternative clothing options that do not restrict the chest or abdomen.
- Request flexible breaks where the patient can go outside for fresh air when needed.
- Communicate by instant messaging or a chat program instead of by telephone.
- Request to work from home in extreme weather (very humid, very cold).
Reduce physical exertion:
- Request tasks that are less physically demanding.
- Use electric tools to replace manual effort.
- Vary repetitive tasks with other duties.
- Arrange an assessment by a physical therapist or occupational therapist, who can recommend appropriate mobility aids to minimize energy expenditure.
- If the patient works standing up, request to be allowed to sit down when possible. Use a stand-lean chair or keep a rest chair nearby.
Modify the work environment:
- Relocate the workstation to an area with sufficient air purification.
- Use a portable humidifier or dehumidifier to produce comfortable air humidity.
- Request a fragrance- and smoke-free policy in the workplace.
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