• Jun Kako, Tatsuya Morita, Takuhiro Yamaguchi, Masamitsu Kobayashi, Asuko Sekimoto, Hiroya Kinoshita, Asao Ogawa, Sadamoto Zenda, Yosuke Uchitomi, Hironobu Inoguchi, and Eisuke Matsushima.
• Section of Liaison Psychiatry and Palliative Medicine, Tokyo Medical and Dental University Graduate School of Medical and Dental Sciences, Tokyo, Japan; Division of Nursing Science, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan; Department of Nursing, National Cancer Center Hospital East, Kashiwa, Chiba, Japan. Electronic address: jkako-tky@umin.ac.jp.
• J Pain Symptom Manage. 2018 Oct 1; 56 (4): 493-500.

ContextDyspnea is a common distressing symptom among patients with advanced cancer.ObjectiveThe objective of this study was to determine the effect of fan therapy on dyspnea in patients with terminally ill cancer.MethodsThis parallel-arm, randomized controlled trial included 40 patients with advanced cancer from a palliative care unit at the National Cancer Center Hospital in Japan. All patients experienced dyspnea at rest with a score of at least three points on a subjective 0- to 10-point Numerical Rating Scale (NRS), showed peripheral oxygen saturation levels of ≥90%, had an Eastern Cooperative Oncology Group grade of 3 or 4, and were aged 20 years or more. In one group, a fan was directed to blow air on the patient's face for five minutes. This group was compared to a control group wherein air was blown to the patient's legs. Patients were randomly assigned to each group. The main outcome measure was the difference in dyspnea NRS scores between fan-to-face and fan-to-legs groups.ResultsNo significant differences were seen in baseline dyspnea NRS between groups (mean score, 5.3 vs. 5.1, P = 0.665). Mean dyspnea changed by -1.35 points (95% CI, -1.86 to -0.84) in patients assigned to receive fan-to-face and by -0.1 points (-0.53 to 0.33) in patients assigned to receive fan-to-legs (P < 0.001). The proportion of patients with a one-point reduction in dyspnea NRS was significantly higher in the fan-to-face arm than in the fan-to-legs arm (80% [n = 16] vs. 25% [n = 5], P = 0.001).ConclusionFan-to-face is effective in alleviating dyspnea in patients with terminally ill cancer.Copyright © 2018 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

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