Management of Dyspnea in a Patient With Lung Cancer

Nine months prior, S.P., a 64-year-old woman, was diagnosed with stage IV non-small cell lung cancer with distant metastases to the bone. Her large tumor burden had compressed both her trachea and esophagus several months earlier, leading to gastrostomy-tube placement for nutrition and tracheostomy for airway management. Palliative radiation was used to shrink the tumor size and allow for removal of the tracheostomy tube, leaving an open area covered with gauze in the middle of her neck—a reminder of her previous struggles with breathing. Unfortunately, the cancer progressed and S.P. was admitted to the hospital for evaluation and management of dysphagia.