Body Positioning for Dyspnea in Patients with Cancer with Unilateral Pleural Effusion: A Pilot Trial

Background: Dyspnea is common in advanced cancer, especially with unilateral pleural effusion. Lateral positioning is widely used, but evidence of effectiveness is limited. Objectives: To assess the feasibility and short-term effects of affected-side-down (PLEUR-DOWN) versus affected-side-up (PLEUR-UP) positioning for dyspnea relief. Design: Multicenter randomized crossover pilot trial. Setting/Subjects: Ten patients with cancer with dyspnea were enrolled at seven hospitals in Japan. Methods: Patients (numerical rating scale [NRS] ≥ 3) were randomized to two sequences. Each position was maintained for five minutes within a washout period. The primary outcome was feasibility, assessed by completion, absence of carryover/period effects, and adherence. Secondary outcomes included NRS changes, patient preference, and safety. Results: All patients completed the trial. No significant carryover (p = 0.57) or period effects (p = 0.25) were found. Mean NRS difference favored PLEUR-DOWN (-0.9; p = 0.34). Half preferred PLEUR-DOWN. No adverse events occurred. Conclusions: The trial confirmed feasibility and supports further research.