Here are the results of a Cochrane review of non-drug options in advanced stages of malignant and non-malignant diseases.

First, the details.

  • Reviewers included studies of the effects of non-pharmacological and non-invasive treatments to relieve breathlessness in patients with advanced stages of cancer, chronic obstructive pulmonary disease (COPD), interstitial lung disease, chronic heart failure, or motor neuron disease.
  • 47 studies in 2532 participants were included.

And, the results.

  • There was high strength evidence that neuro-electrical muscle stimulation and chest wall vibration could relieve breathlessness.
  • Moderate strength for using walking aids and breathing training.
  • Low strength of evidence supporting acupuncture/acupressure.
  • Not enough data to judge the effectiveness of distractive auditory stimuli (music), relaxation, fan, counseling and support, counseling and support with breathing-relaxation training, case management and psychotherapy.
  • Most studies were conducted in COPD patients; only a few in other conditions.

The bottom line?
The authors concluded, “Breathing training, walking aids, neuro-electrical muscle stimulation, and chest wall vibration appear to be effective non-pharmacological interventions for relieving breathlessness in advanced stages of disease.”

3/16/09 21:11 JR

Hi, I’m JR

John Russo, Jr., PharmD, is president of The MedCom Resource, Inc. Previously, he was senior vice president of medical communications at, a complementary and alternative medicine website.