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LTOT in Cancer with Hypoxaemia — SCE Palliative Medicine MCQ

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ModerateRespiratory SymptomsLTOT in Cancer with HypoxaemiaSCE Palliative Medicine

A 65‑year‑old woman with advanced breast cancer and pulmonary lymphangitis carcinomatosis has progressive breathlessness despite dexamethasone and low‑dose morphine. Her oxygen saturations are 85% on air. Is long‑term oxygen therapy (LTOT) appropriate?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: A — Yes – she meets criteria for palliative oxygen (hypoxaemia with resting SpO₂ < 92%) and oxygen may relieve breathlessness even in this palliative context

Option A is correct. She fulfils UK‑defined criteria for ‘palliative oxygen therapy’: documented hypoxaemia (SpO₂ 85%, below the <92% threshold) plus intractable breathlessness despite maximal therapy. The NHS ‘Good HOOF’ guide supports initiation of oxygen promptly in such cases for symptomatic benefit. Option D is incorrect because cancer patients may receive oxygen if hypoxaemic. Option E is false—oxygen may help when hypoxaemia is present. Option C is invalid—oxygen is used across diagnoses. Option B is misleading—the usual 3‑month formal LTOT assessment is bypassed in palliative oxygen prescribing for symptom relief.

Reference: NHS England Good HOOF Guide for primary care and out of hours teams (2020), https://www.england.nhs.uk/coronavirus/documents/good-hoof-guide-for-primary-care-and-out-of-hours-teams-november-2020/