Brief Behavioral Intervention for Dyspnea in Patients With Advanced Lung Cancer

This research study is evaluating a behavioral intervention designed to help people with advanced lung cancer manage dyspnea (i.e., breathlessness or shortness-of-breath).

Many individuals with advanced lung cancer experience debilitating breathlessness at some point during the course of their illness. Unfortunately, few interventions exist to treat this distressing symptom of cancer. The purpose of this study is to test the efficacy of a brief behavioral intervention may help relieve breathlessness in individuals with advanced lung cancer. Participants will have a 50/50 chance of receiving the behavioral intervention or standard care. The principal investigator of the study, Dr. Joseph Greer, is a licensed clinical psychologist who has trained oncology nurses in how to deliver the behavioral intervention. The oncology nurses will meet with participants during their outpatient oncology appointments, such as chemotherapy infusions, to review the behavioral skills that may help with breathlessness. This intervention involves no medications but rather teaches patients skills for breathing control and relaxation of the body.

Dyspnea intervention will be administered over two sessions Patients will receive: Psychoeducation Relaxation training for reducing physiological stress Behavioral techniques for managing acute breathlessness

Dyspnea intervention will be administered over two sessions Patients will receive: Psychoeducation Relaxation training for reducing physiological stress Behavioral techniques for managing acute breathlessness

Compare the change between study groups in self-reported leisure time physical activity score from baseline to 8 weeks

Compare the change between study groups in the percentage of time spend immobile but awake on actigraphy

Compare changes in anxiety and depression symptoms between study groups over the 24-week study period

Compare changes in self-reported leisure time physical activity score between study groups over the 24-week study period

Examine the degree to which intervention effects on patient reported outcomes are mediated by improved mastery in managing breathlessness (as measured by the Chronic Respiratory Disease Questionnaire)

Examine whether differences in reported dyspnea are moderated by patient demographic and clinical factors

Inclusion Criteria: A diagnosis of either NSCLC, SCLC, or mesothelioma, not being treated with curative intent Self-reported shortness of breath (a score of 2 or greater on the Modified Medical Research Council Dyspnea Scale) Eastern Cooperative Oncology Group (ECOG) Performance Status from 0 (asymptomatic) to 2 (symptomatic and in bed <50% of day) The ability to read and respond to questions English Primary cancer care at the Massachusetts General Hospital (MGH) Cancer Center or Dana-Farber Cancer Institute (DFCI) Age >18 years Exclusion Criteria: Cognitive or psychiatric conditions prohibiting study consent or participation. A treating clinician who reports that the patient is inappropriate for the study