Testing strategies to improve breathlessness and related symptoms in people with lung cancer

INTERVENTION: The intervention combines breathing re‐training with individualised psychosocial support, delivered using evidence based psycho‐educational strategies to improve breathlessness and additional intervention components which focus on reducing the impact of co‐occurring symptoms on dyspnoea (cough, pain, fatigue, anorexia) in the form of a face‐to‐face instructional session of about 60 minutes delivered by experienced registered nurses, followed by weekly phone calls for 3 weeks. The instruction is supplemented by a range of resources to reinforce intervention delivery and promote self‐management, including audio recordings, printed fact sheets, an individualised management plan, as well as communication and referral to a relevant health provider in the community (GP, Practice Nurse or Community/Domiciliary Nurse). CONDITION: Lung cancer PRIMARY OUTCOME: Performance status assessed by the Australia‐modified Karnofsky Performance Scale; The primary outcome of this pilot study is to the feasibility of a multicomponent non‐pharmacological intervention in improving cancer patients' ability to manage breathlessness and the related cluster of symptoms associated with breathlessness. Assessment of feasibility includes recruitment issues, likely attrition rates and acceptability of interventions (measured by dropout rates due to the nature of intervention during the study), which are essential for consideration in planning a larger clinical trial. It will also help determine the effect size for sample size estimation to adequately power a future larger clinical trial. SECONDARY OUTCOME: Anxiety and depression assessed using the 14‐item 4‐point Hospital Anxiety and Depression Scale; Breathlessness severity, distress and impact ‐ 5 items 11 point Numeric Rating Scale Severity of co‐occurring symptoms (cough, pain, fatigue, anorexia) assessed by the 7‐item 11‐point (0‐10) Symptom Assessment Scale; Use of non‐pharmacological methods for managing breathlessness and co‐occurring symptoms at 4 and 8 weeks; the scale includes two sub‐scales: the first including items assessing use of strategies for improving breathing efficiency and effectiveness, and the second assessing use of psychosocial support strategies. For each item, patients report whether or not they have used the specific strategy in the past week and, if used, to rate on a four point scale from 'not at all' to 'very much' how useful the strategy was in reducing their breathlessness. INCLUSION CRITERIA: Diagnosed with a primary or secondary lung cancer; life expectancy of at least 3 months; completed first line therapy; have an average dyspnoea rating > 2 on an 11 point numeric rating scale in the past week