Do beta-blockers alter dyspnea and fatigue in advanced lung cancer? A retrospective analysis

Palliat Med. 2012 Sep;26(6):797-803. doi: 10.1177/0269216311415454. Epub 2011 Aug 15.

Abstract

Introduction: Dyspnea is common in lung cancer and may be partially attributable to increased ventilatory drive due to muscle weakness. The sympathetic component of this pathway might be mitigated by β-blockers.

Methods: A retrospective review of new patients with stage III-IV non-small lung cancer or any small cell lung cancer was undertaken to assess the impact of β-blocker use on dyspnea and fatigue. Data were abstracted for clinical characteristics, β-blocker use, and pre-treatment Edmonton Symptom Assessment System dyspnea and fatigue scores.

Results: Of 348 patients assessed, 202 met eligibility criteria. The median age was 67, 55.4% were female, 18.8% had chronic obstructive pulmonary disease (COPD), and 5.9% had active coronary artery disease. Over 60% of patients scored 4/10 or higher on their dyspnea and fatigue scores. While dyspnea and fatigue were moderately associated, no association was found between β-blocker use and either symptom. Recorded dosages of β-blockers were low. COPD was associated with dyspnea and fatigue, while anemia was associated with fatigue.

Conclusions: Dyspnea and fatigue are prevalent and increased in the presence of COPD and anemia. No association between β-blocker use and dyspnea or fatigue scores was observed. This may be attributable to inadequate dosing or to retrospective bias.

MeSH terms

  • Adrenergic beta-Antagonists / therapeutic use*
  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Non-Small-Cell Lung / complications*
  • Dyspnea / drug therapy*
  • Dyspnea / etiology
  • Fatigue / drug therapy*
  • Fatigue / etiology
  • Female
  • Humans
  • Lung Neoplasms / complications*
  • Male
  • Middle Aged
  • Retrospective Studies
  • Severity of Illness Index

Substances

  • Adrenergic beta-Antagonists