Impact of physical activity on fatigue and quality of life in people with advanced lung cancer: a randomized controlled trial

Dhillon, Haryana M.; Bell, Melanie L.; Ploeg, Hidde P. van der; Turner, Jane; Kabourakis, Michael; Spencer, Lissa; Lewis, Craig; Hui, Rina; Blinman, Prunella; Clarke, Stephen; Boyer, Michael; Vardy, Janette

doi:10.1093/annonc/mdx205

Cited by 92 publications

(142 citation statements)

References 23 publications

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“…In this regard, a trial randomized 112 patients with lung cancer (NSCLC stage III–IV and SCLC) to 8‐week supervised and unsupervised PA sessions plus a behavioral support program, and general health education materials or control (general health education material only). After the intervention, at 4 and 6 months, no significant changes were detected in terms of fatigue, QoL, symptom severity, physical or functional status, and survival between the two groups . Nevertheless, the engagement in an EX program was never associated with an exacerbation in fatigue levels.…”

Section: Investigated Outcomes In Lung Cancermentioning

confidence: 83%

“…The tai chi group reported an improvement in total fatigue score compared with the control group at 6 weeks (59.6 ± 11.3 vs. 66.8 ± 11.9, p < .05) and 12 weeks (53.3 ± 11.8 vs. 59.3 ± 12.2, p < .05) . Although these findings seem to support the benefit of EX for cancer‐related fatigue in lung cancer, other interventional studies reported no changes in fatigue levels after a targeted exercise program . In this regard, a trial randomized 112 patients with lung cancer (NSCLC stage III–IV and SCLC) to 8‐week supervised and unsupervised PA sessions plus a behavioral support program, and general health education materials or control (general health education material only).…”

Section: Investigated Outcomes In Lung Cancermentioning

confidence: 94%

“…Similarly, a recent study including patients with surgically resected NSCLC (stage I–II) detected a significant VO 2peak increment in the EX group versus control . Globally considered, although some studies did not report any significant change in functional capacity following a training period , the majority agreed on the potential beneficial effect of exercise on cardiorespiratory fitness .…”

Section: Investigated Outcomes In Lung Cancermentioning

confidence: 98%

“…Focusing on studies including only patients with lung cancer, no clear advantage in terms of QoL after applying a physical exercise program is evident . A randomized controlled trial attempted to assess the impact of EX intervention on QoL in 81 patients undergoing thoracotomy.…”

Section: Investigated Outcomes In Lung Cancermentioning

confidence: 99%

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Physical Activity and Exercise in Lung Cancer Care: Will Promises Be Fulfilled?

Avancini

Sartori

Gkountakos³

et al. 2019

The Oncologist

114

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Lung cancer remains the leading cause of cancer‐related death worldwide. Affected patients frequently experience debilitating disease‐related symptoms, including dyspnea, cough, fatigue, anxiety, depression, insomnia, and pain, despite the progresses achieved in term of treatment efficacy. Physical activity and exercise are nonpharmacological interventions that have been shown to improve fatigue, quality of life, cardiorespiratory fitness, pulmonary function, muscle mass and strength, and psychological status in patients with lung cancer. Moreover, physical fitness levels, especially cardiorespiratory endurance and muscular strength, are demonstrated to be independent predictors of survival. Nevertheless, patients with lung cancer frequently present insufficient levels of physical activity and exercise, and these may contribute to quality of life impairment, reduction in functional capacity with skeletal muscle atrophy or weakness, and worsening of symptoms, particularly dyspnea. The molecular bases underlying the potential impact of exercise on the fitness and treatment outcome of patients with lung cancer are still elusive. Counteracting specific cancer cells’ acquired capabilities (hallmarks of cancer), together with preventing treatment‐induced adverse events, represent main candidate mechanisms. To date, the potential impact of physical activity and exercise in lung cancer remains to be fully appreciated, and no specific exercise guidelines for patients with lung cancer are available. In this article, we perform an in‐depth review of the evidence supporting physical activity and exercise in lung cancer and suggest that integrating this kind of intervention within the framework of a global, multidimensional approach, taking into account also nutritional and psychological aspects, might be the most effective strategy. Implications for Practice Although growing evidence supports the safety and efficacy of exercise in lung cancer, both after surgery and during and after medical treatments, most patients are insufficiently active or sedentary. Engaging in exercise programs is particularly arduous for patients with lung cancer, mainly because of a series of physical and psychosocial disease‐related barriers (including the smoking stigma). A continuous collaboration among oncologists and cancer exercise specialists is urgently needed in order to develop tailored programs based on patients’ needs, preferences, and physical and psychological status. In this regard, benefit of exercise appears to be potentially enhanced when administered as a multidimensional, comprehensive approach to patients’ well‐being.

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Section: Investigated Outcomes In Lung Cancermentioning

confidence: 83%

Section: Investigated Outcomes In Lung Cancermentioning

confidence: 94%

Section: Investigated Outcomes In Lung Cancermentioning

confidence: 98%

Section: Investigated Outcomes In Lung Cancermentioning

confidence: 99%

See 2 more Smart Citations

Physical Activity and Exercise in Lung Cancer Care: Will Promises Be Fulfilled?

Avancini

Sartori

Gkountakos³

et al. 2019

The Oncologist

114

View full text Add to dashboard Cite

show abstract

“…We identified that exercise studies all included practice and frequently used self‐monitoring BCTs; however, less than half used goal setting or generalisation of behaviours away from the clinical setting. Pedometers to support step count goal setting were used in 1 exercise study; however, their potential to enhance behaviour change remains uncertain . Other BCTs associated with positive study outcomes were identified less frequently in our review.…”

Section: Discussionmentioning

confidence: 99%

Changing health behaviour with rehabilitation in thoracic cancer: A systematic review and synthesis

et al. 2018

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Nonpharmacological Interventions for Managing Breathlessness in Patients With Advanced Cancer

et al. 2021

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IMPORTANCE Breathlessness is a frequent and debilitating symptom in patients with advanced cancer. Often, in the context of breathlessness, aggressive cancer treatment is not beneficial, feasible, or aligned with goals of care. Targeted symptom-focused interventions may be helpful in this scenario.OBJECTIVE To evaluate the advantages and harms of nonpharmacological interventions for managing breathlessness in adults with advanced cancer.EVIDENCE REVIEW PubMed, Embase, CINAHL, Web of Science, and the Cochrane Central Register of Controlled Trials were searched from inception through May 2020 for published randomized clinical trials (RCTs), nonrandomized controlled trials, and observational studies of the advantages and/or harms of nonpharmacological interventions on alleviating breathlessness in adults with advanced cancer. Only English-language studies were screened for eligibility, titles, abstracts, and full text. Risk of bias and strength of evidence (SOE) were independently assessed. The key outcomes reported in studies were breathlessness, anxiety, exercise capacity, health-related quality of life, and harms. Data were analyzed from October 1, 2019, to June 30, 2020.FINDINGS A total of 29 RCTs (2423 participants) were included. These RCTs evaluated various types of interventions, such as respiratory (9 RCTs), activity and rehabilitation (7 RCTs), behavioral and psychoeducational (3 RCTs), integrative medicine (4 RCTs), and multicomponent (6 RCTs). Several nonpharmacological interventions were associated with improved breathlessness, including fan therapy (standardized mean difference [SMD], −2.09; 95% CI, −3.81 to −0.37; I 2 = 94.3%; P for heterogeneity = .02; moderate SOE) and bilevel ventilation (estimated slope difference, −0.58; 95% CI, −0.92 to −0.23; low SOE), lasting for a few minutes to hours, in the inpatient setting. In the outpatient setting, nonpharmacological interventions associated with improved breathlessness were acupressure and reflexology (integrative medicine) (low SOE) and multicomponent interventions (combined activity and rehabilitation, behavioral and psychoeducational, and integrative medicine) (low SOE) lasting for a few weeks to months. Five of the 29 RCTs (17%) reported adverse events, although adverse events and study dropouts were uncommon.CONCLUSIONS AND RELEVANCE Findings of this review include the safety and association with improved breathlessness of several nonpharmacological interventions for adults with advanced cancer. Guidelines and clinical practice should evolve to incorporate nonpharmacological interventions as first-line treatment for adults with advanced cancer and breathlessness.

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Impact of physical activity on fatigue and quality of life in people with advanced lung cancer: a randomized controlled trial

Abstract: Australian New Zealand Clinical Trials Registry No. ACTRN12609000971235.

Cited by 92 publications

References 23 publications

Physical Activity and Exercise in Lung Cancer Care: Will Promises Be Fulfilled?

Physical Activity and Exercise in Lung Cancer Care: Will Promises Be Fulfilled?

Changing health behaviour with rehabilitation in thoracic cancer: A systematic review and synthesis

Nonpharmacological Interventions for Managing Breathlessness in Patients With Advanced Cancer

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