Do patients with lung cancer benefit from physical exercise?

Abstract

Background. Patients with lung cancer are often burdened by dyspnoea, fatigue, decreased physical ability and loss of weight. Earlier studies of physical exercise of patients with COPD have shown promising results. The aim of this study was to investigate, if a well-documented COPD rehabilitation protocol can improve physical fi tness and quality of life (QoL) in patients with lung cancer. Material and methods. Forty-fi ve patients, with a minimum walking distance of 50 meters, absence of cognitive defi cits or severe heart disease and motivated for physical training were invited to an exercise intervention. The intervention consisted of seven weeks of twice weekly training, focusing on walking training, circuit training, handling of dyspnoea and instructions in daily diary-based training at home. Prior to, and after the intervention, Incremental-and Endurance Shuttle Walk Test (ISWT and ESWT) were performed, and pulmonary function as well as self-reported QoL (EORTC-QLQ-C30 and LC13) were measured. Results. Fourteen subjects dropped out before commencement of the intervention. Seven were excluded after physiotherapeutic evaluation. Of the remaining 24, three were excluded because of insuffi cient attendance (Ͻ 65% of scheduled exercise sessions) thus 21 patients completed the intervention. For 17 patients with complete pre-and post intervention data, ISWT increased 9% (Ϫ77 to 39%) (median and range) (p ϭ 0.021), while ESWT increased 109% (Ϫ70 to 432%) (p ϭ 0.002). Twelve of 17 improved in ISWT, while 15 improved in ESWT. No changes in pulmonary function and improvements in QoL were observed. Conclusion. Patients with pulmonary cancer can achieve signifi cant improvements in physical fi tness measured with ISWT and ESWT after completion of the intervention program. No changes in pulmonary function and QoL were observed. In addition, we found that a large number of patients dropped out before intervention and that the patients, who succeeded, often discontinued training at home.

Effects of systematic rehabilitation programs on quality of life in patients undergoing lung resection

“…Therefore, provision of the appropriate treatment and care programs for controlling the disease and improving the patient QOL remains a fundamental issue. A multidimensional therapeutic approach is recommended including pulmonary rehabilitation (6,7) and an adequate level of physical activity (8,9) in order to improve exercise tolerance, health-related QOL as well as surgical candidacy and to decrease surgical morbidity. Recent studies have shown that physical activity may have important benefits on lung cancer patients and survivors (10)(11)(12), regardless of the disease stage (13) or limited physical activity (14,15).…”

Câncer de pulmão: reabilitação

“…Although the few studies with lung cancer patients have not revealed any consistent results, [4][5][6][7] we recommend these patients regularly spend at least 150 minutes per week (spread out over 5 days) in physical, aerobic, and resistance training, either combined or separately, and supervised at first. The few studies made with this population were not sufficient and well-enough designed for us to conclude that exercising does not help with the symptoms of the disease, with the fatigue, and with their quality of life.…”

Pulmonary Rehabilitation in Patients with Lung Cancer

“…Diğerleri ise cerrahi girişime uygun olan hastalarda ameliyat öncesi (23)(24)(25)(26)(27), ya da sonrası dönemde egzersiz eğitiminin ön planda olduğu araştırmalardır (14,(28)(29)(30)(31). Birkaçında ileri evre akciğer kanserinde hastane içi PR uygulamaları da yapılmıştır (32)(33)(34). Bu araştırmaların hiçbirinde kontrol grubu yoktur (14,(23)(24)(25)(26)(27)(28)(29)(30)(31).…”

“…Bu araştırmaların hiçbirinde kontrol grubu yoktur (14,(23)(24)(25)(26)(27)(28)(29)(30)(31). Hasta sayıları azdır (24,25,27,28,(30)(31)(32)34). Hepsinin birleştiği ortak nokta, hastaların egzersiz kapasitelerinin artmasıdır.…”

“…Araştırmacılar 8 haftalık hastane içi rehabilitasyon programıyla akciğer kanserli hastaların egzersiz kapasitelerinin artması nedeniyle, bu hastaların PR programları için iyi birer aday oldukları sonucuna varmışlardır (28). Rezeksiyon sonrası egzersiz eğitimi ile hastaların dispnelerinin azaldığı da çeşitli çalışmalarla gösterilmiştir (28,34,35). Akciğer kanserli hastaların onkolojik rehabilitasyonun bir parçası olarak hastane içinde uygulanan standart aerobik endurans eğitiminin verildiği egzersiz programlarından, hem fizyolojik hem de psikolojik açıdan yararlandıkları, hastaların yaşam kalitelerinin arttığı belirtilmiştir (14).…”