The experience of being breathless can be frightening both for patient and family, and it can affect individuals not only physically but also emotionally and socially. It is a common symptom in ill health, particularly in cancer where it is experienced by 50–70% of patients (Edmonds et al., 2001), and to treat it successfully requires a combination of pharmacological and non-pharmacological measures.

The prevalence of breathlessness can make it difficult to attribute it to a cause; however, attempting to do so is necessary if potentially reversible causes are to be identified. It is useful to consider causes of breathlessness as either cancer-related (airway obstruction, pleural effusion, anaemia, ascites), treatment-related (surgery, radiotherapy, drugs causing fluid retention) or other causes (infection, cardiac disease, chronic respiratory disease, pulmonary oedema).

Assessment requires a detailed discussion which may be difficult for the patient; the presence of a carer might be helpful.

Early developments in managing breathlessness identified its complex nature and suggest, with the emotional experience being inseparable from the sensory experience, that assessment must address the many dimensions if management strategies are to deal with it effectively. This complex understanding of breathlessness has developed further, even being described as “total breathlessness” in order to address the physical, psychological, social and spiritual domains (Corner and O’Driscoll, 1999).