Lung Cancer Patients Respond to Encouragement to Exercise

It’s been known for several decades that exercise and physical activity provide benefits for patients with many types of cancer, while undergoing treatment and after. But for people with lung cancer, the idea of exercising may be overwhelming because of symptoms, such as shortness of breath, coughing, and fatigue, particularly if their physicians have not encouraged them to be active or recommended a physical activity program.¹

Numerous studies have examined the effects of physical activity among patients with lung cancer. A 2012 study from Denmark looked at 25 patients with stage III/IV non-small cell cancer (NSCLC), and four patients with extensive disease small cell lung cancer (SCLC-ED). They participated in a 6-week supervised structured exercise and relaxation training program.² The researchers found that of the 23 patients who completed the program, the majority (73.0%) adhered to the program and there were significant improvements in VO2 peak and 6-minute walking distance, as well as in muscle strength. The patients also reported a significant improvement in emotional well-being.

These findings are consistent with those of a study from Germany published in 2014.³ This slightly larger study included 40 patients with predominantly advanced NSCLC, who were receiving simultaneous or sequential radiochemotherapy or chemotherapy alone. Thirty-one patients completed the 8-week study. In their conclusion, the authors wrote, “In this pilot study, endurance and strength capacity improved over time, indicating the rehabilitative importance of the applied intervention.”

However, a recent review, published in the Journal of Thoracic Oncology, which also looked at the safety benefits and utility of exercise and pulmonary rehabilitation among patients with lung cancer, found that despite benefits provided by exercising, physicians are not advising their patients early enough or often enough to be as physically active as possible.⁴ “Despite the increased interest in this subject over the last few years, a validated exercise regimen has not been established for perioperative or advanced-stage disease,” the authors wrote.

Exercise before surgery has multiple benefits and may be even more beneficial than postsurgery exercise, they noted. And patients who are not candidates for surgery may also benefit from exercise, which may improve their physical tolerance and symptom burden, which in turn, adds to quality of life.

The researchers also found that, in general, patients wanted to be counseled by their physician about exercise during treatment for lung cancer and afterward. And, when they did receive this type of advice from their physicians, there was a greater likelihood that the patients would comply with an exercise program. “Clinicians underutilize exercise and pulmonary rehabilitation as a therapy, in part due to the lack of evidence-based consensus as to how and when to implement increasing physical activity,” the researchers concluded.

References:

1. Science Daily. (2015). Physical activity benefits lung cancer patients, survivor.
2. Quist M, Rorth M, Langer S, et al. (2012). Safety and feasibility of a combined exercise intervention for inoperable lung cancer patients undergoing chemotherapy: A pilot study. Lung Cancer, 75(2): 203-208.
3. Kuehr L, Wiskemann J, Abel U, et al. (2014). Exercise in Patients with Non-Small Cell Lung Cancer. Medicine & Science in Sports & Exercise, 46(4):656-663.
4. Bade BC, Thomas DD, Scott JB, et al. (2015). "Increasing Physical Activity and Exercise in Lung Cancer: Reviewing Safety, Benefits, and Application". Journal of Thoracic Oncology.