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, which is difficult or laboured breathing, and breathlessness, a similar condition characterized by a feeling of shortness of breath. Breathing problems are present in 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 treatments, anemia, infection, deconditioning, pre-existing lung disease and cancer itself.
Vocational implications
The extent to which breathing problems affect your ability to perform your job depends on the severity of the symptoms you experience and the demands of your work. Physically demanding jobs may be more challenging for those with breathing problems.
What you can do
Speak to your healthcare team for advice about the cause and management of your specific breathing problems. Note the severity of your breathing difficulties and any situations that make your breathing worse or better. Treat any underlying condition when possible. Medications may be helpful in reducing the severity of your symptoms. When fluid in the lungs is causing the breathing problems, the fluid may be removed. Other strategies include:
- learning breathing techniques, such as pursed lip and abdominal breathing
- relaxation training
- learning how to position your body to breathe most easily
- conserving energy
- regular exercise as tolerated
Job accommodations
Modify your work tasks and how you work:
- Wear loose-fitting, comfortable clothing. If your work requires a uniform, request alternative clothing options that do not restrict your chest or abdomen.
- Request flexible “fresh-air” breaks.
- Arrange for communication over instant messaging or a chat program instead of the telephone.
- Request to work from home in extreme weather (very humid, very cold).
- Reduce physical exertion:
- Do tasks that are less physically demanding.
- Use electric tools to replace manual effort.
- Reduce repetitive tasks; vary these tasks with other duties.
- Consider using a mobility aid such as a walker.
- Other mobility aids may also be helpful to minimize your energy expenditure. Assessment by a local therapist (physical therapist, occupational therapist) may be best to help you find the appropriate mobility aid.
- Work in a standing position? Sit down when you’re able to. Use a stand-lean chair if possible; if not, keep a rest chair nearby.
- Learn deep breathing techniques. Incorporate relaxation into your breaks—with or without an audio guide.
Modify your work environment:
- Relocate your workstation to an area with sufficient air purification.
- Optimize air humidity: consider a portable humidifier or dehumidifier for comfort.
- Request that your workplace abides by a fragrance- and smoke-free policy.
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Nausea and vomiting
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