<p>Advanced malignant and benign lung diseases place a&#xa0;burden on those affected and their families in many ways. In addition to limitations in the quality of life and daily living skills and the awareness of an increased risk of death, patients are particularly challenged by the symptom of dyspnea. Shortness of breath is a&#xa0;subjective perception and can vary in intensity and nature. Chronic shortness of breath, in particular, is difficult to treat and is often reported by people with severe respiratory diseases as the most distressing symptom. In view of this aspect it is regrettable that shortness of breath in patients with advanced lung diseases is frequently recognized and treated only at a very late stage. In the treatment of shortness of breath, in addition to treating the underlying disease, nonpharmacological treatment, such as breathing exercises, the use of assistive devices and handheld fans as well as behavioral therapy measures, are considered evidence-based symptom-relieving therapies. The use of opioids for the treatment of dyspnea in treatment-refractory situations is justified. Within the framework of individualized treatment plans with careful symptom assessment and monitoring of side effects, opioids have an important place.</p>