Patient case (clinical description): A 61-year-old man comes to the clinic due to nonproductive cough and progressive dyspnea.  The patient's medical conditions include hypertension, hypercholesteremia and peptic ulcer disease.  He smokes 2 packs of cigarettes daily for the past 30 years.  On examination, there are decreased breath sounds and percussive dullness at the base of the left lung.  Other vital signs are normal. Abdomen is soft without tenderness. CT scan shows a left-sided pleural effusion and nodular thickening of the pleura. The plural fluid was bloody on thoracentesis. Biopsy shows proliferation of epithelioid-type cells with very long microvilli.

Patient's own account: I am 61 and I had to go to the clinic because I couldn't stop coughing and I experienced some breath shortness. I suffer from hypertension and cholesterol and I also have a stomach ulcer. I should admit that I've been smoking 2 packs of cigarettes every day for the past 30 years. My doctor told me that my breath in my left lung sounds bad. But he told me that my blood pressure, heart rate, breathing rate and temperature are normal. My belly is also normal. However my X-Rays show some liquid on the left side and a mass where the liquid got hard. The scary thing is that the liquid was bloody when they got it out. They did a biopsy and it showed that I have an increase of epithelioid-type cells with very long microvilli.

Clinical trial: Breath Training Exercise for the Reduction of Chronic Dyspnea

Eligibility criteria:
Inclusion Criteria:

          -  >18 years of age

          -  Diagnosis of a chronic pulmonary disorder (a diagnosis of lung cancer is not required
             as the symptom of dyspnea, not cancer itself, is targeted)

          -  If diagnosed with lung cancer, must have completed definitive treatment more than 6
             months prior

          -  At least moderate dyspnea defined by a BDI score of 6 or less in the Self-
             Administered Computerized Versions of the Baseline and Transition Dyspnea
             Indexes(SAC-BDI/TDI)13,14 (This cutoff score is close to the score of 5.7 used to
             define "moderate dyspnea" in the publication that validated the instrument and is
             selected by attending physicians in the Pulmonary Service as a good indication of
             "moderate dyspnea" in clinical practice. A typical person with BDI of 6, for example,
             would be a 52 year old woman who has to pause when walking because of dyspnea and/or
             has eliminated doing an activity because of dyspnea).

          -  Able to safely complete the Six Minute Walk Test (6MWT)15 as per attending physician's
             clinical judgment.

          -  Respiratory functions clinically stable for the preceding 3 months and expected to be
             stable for the next 3 months as determined by project PIs and other Pulmonary Medicine
             faculty.

        Exclusion Criteria:

          -  Life expectancy less than 6 months

          -  Any cause of dyspnea that is determined by the investigators as readily reversible by
             other means (e.g. pleural effusion, pulmonary embolism, acute infection, anemia
             Hb<9.0, etc.)

          -  Non-English speaking
No condition on gender to be admitted to the trial.
No healthy subjects accepted to join the trial.
Subject must be at least 19 Years old.


Eligibility (NLI label): Contradiction