ABSTRACT
This chapter presents a case study of John, who is a 54-year-old man who had a surgery for a carcinoma of the colon. Despite liver metastases he has been managing well until he was found to have a pleural effusion. Antibiotics are important in treating breathlessness caused by a chest infection. Nabilone is a derivative of cannabis and is a bronchodilator with central effects that together can ease breathlessness in some patients. The usual dose is 200–500 microg 8-hourly. Steroids may reduce enough oedema around lung metastases to free up more normal lung for gas exchange. One useful exercise is to teach the patient to relax their shoulders when they are breathless, since they are often tensed up during breathless episodes and letting the shoulders relax down increases the lung capacity to take in air. Massage can help the shoulders relax.
