The effect of breathing exercises on pain, dyspnea and functionality in terminal stage cancer patients receiving palliative care

Objective: We aimed to evaluate physiological, hematological, and effects of symptom with structured breathing exercises in terminal stage cancer patients receiving palliative care. Methods: This study consists of 39 participants of terminal stage cancer patients receiving palliative care in Eyüpsultan State Hospital. Participants were randomly assigned to an intervention group (n=22) and a control group (n=17). The intervention group joined in a structured breathing exercise program by a physiotherapist. This structured breathing exercise includes diaphragmatic and pursed-lip breathing techniques. Physiological parameters (SpO₂, pulse), hematological markers (hemoglobin, leukocyte, platelet, CRP), and symptom scales (VAS, CDS, ESAS-r) were assessed before and after the intervention. İntervention was continued 5 days. Data were analyzed using SPSS Statistics 27. Normality was tested using the Kolmogorov–Smirnov test, and appropriate parametric or non-parametric tests were applied accordingly. Results: The most significant improvement was observed in SpO₂ levels. Oxygen saturation significantly increased in the intervention group. But in the control groups SpO2 declined. At the same time, the pulse decreased in the intervention group. This situation shows enhanced parasympathetic activity and relaxation. Hemoglobin, leukocyte and platelet levels showed no significant change. However, CRP remained stable in the intervention group and tended to rise in the control group. Regarding symptom evaluation, the intervention group exhibited significant reductions in dyspnea (effort, discomfort, anxiety), pain, appetite loss, fatigue, and anxiety. In contrast, the control group showed no notable improvement, and some symptoms worsened. Conclusion: Structured breathing exercises are a safe, feasible, and effective complementary intervention in terminal-stage cancer patients. The exercises improved oxygenation, reduced the overall symptom burden, and contributed positively to both physical and psychological well-being. These findings support the integration of respiratory-based non pharmacological approaches into palliative care protocols.