Dexamethasone in Controlling Dyspnea in Patients With Cancer

PRIMARY OBJECTIVES: I. Compare the intensity of dyspnea (numeric rating scale \[NRS\]) in the dexamethasone arm with that in the placebo arm at week 1. SECONDARY OBJECTIVES: I. Compare the effects of dexamethasone with those of placebo in terms of personalized dyspnea response (based on a personalized dyspnea goal), unpleasantness of dyspnea, other symptoms, health-related quality of life, respiratory physiologic function, and adverse effects at week 1 and week 2, as well as the intensity of dyspnea at week 2. II. Identify predictive markers of dyspnea response to dexamethasone. OUTLINE: Patients are randomized to 1 of 2 groups. GROUP I: Patients receive dexamethasone orally (PO) twice daily (BID) on days 1-28 in the absence of disease progression or unacceptable toxicity. GROUP II: Patients receive placebo PO BID on days 1-14 and dexamethasone PO BID on days 15-28 in the absence of disease progression or unacceptable toxicity. After completion of study treatment, patients are followed up at days 28 and 42.