Respiratory symptoms are a significant issue for many palliative care patients and occur with increasing frequency in the terminal stage of most life-limiting conditions. Although the prevalence and severity of respiratory symptoms will vary depending on the condition between 50 and 70 per cent of patients with cancer, 50 per cent of patients with heart failure will have breathing issues of some kind.  The rates increase to 95 per cent in patients with lung cancer or COPD. 
The main palliative diagnoses causing breathing problems are: primary lung cancer; other cancer involving lung or chest wall, or obstructing the airways or mediastinum; lymphangitis carcinomatosis; end-stage cardiac failure; end-stage respiratory failure; and neuromuscular diseases e.g. Motor Neurone Disease, imminently dying people.
Potentially treatable factors that contribute to respiratory issues should be sought and treated if appropriate. These include:
The main respiratory symptoms likely to be encountered in a palliative care context are dyspnoea and obstruction. Synthesis of the evidence relating to these and other respiratory symptoms is provided separately in the corresponding sub-sections. See:
See individual sub-sections for more on practice implications in Cough, Dyspnoea, Haemoptysis, and Obstruction. In brief:
Last updated 27 August 2021