Exercise in Patients with Non–Small Cell Lung Cancer

Kuehr, Lea; Wiskemann, Joachim; Abel, Ulrich; Ulrich, Cornelia M.; Hummler, Simone; Thomas, Michael

doi:10.1249/mss.0000000000000158

Cited by 73 publications

(93 citation statements)

References 20 publications

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“…25 The 6MWT, which has demonstrated good reliability and validity in chronic obstructive pulmonary disease (COPD) patients, 26 has also been used in several studies to demonstrate functionality in patients with lung cancer. 7,27 With regard to lung capacity, forced expiratory volume in 1 second (FEV 1 ) was measured using a spirometer (piko-6, Ferraris Respiratory), which has demonstrated good reliability and validity in COPD patients. 28 FACT-General and FACT-L were used to evaluate HRQoL and cancer-related symptoms.…”

Section: Methodsmentioning

confidence: 99%

“…These studies, however, have enrolled small populations (n range from 24 to 46) and have dropout rates of 20.7% to 56% and present data on few patients (n = 11 -31). All the studies [5][6][7][8] found improvements in physical and functional capacity but failed to show improvements in overall HRQoL, anxiety, or depression. These results represent 164 patients with advanced-stage lung cancer, but only data on 118 patients were evaluated.…”

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confidence: 99%

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The Impact of a Multidimensional Exercise Intervention on Physical and Functional Capacity, Anxiety, and Depression in Patients With Advanced-Stage Lung Cancer Undergoing Chemotherapy

et al. 2015

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Introduction. Patients with advanced-stage lung cancer face poor survival and experience co-occurring chronic physical and psychosocial symptoms. Despite several years of research in exercise oncology, few exercise studies have targeted advanced lung cancer patients undergoing chemotherapy. The aim of the present study was to investigate the benefits of a 6-week supervised group exercise intervention and to outline the effect on aerobic capacity, strength, health-related quality of life (HRQoL), anxiety, and depression. Methods. VO2peak was assessed using an incremental exercise test. Muscle strength was measured with one repetition maximum test (1RM). HRQoL, anxiety, and depression were assessed using Functional Assessment of Cancer Therapy–Lung (FACT-L) scale and the Hospital Anxiety and Depression Scale (HADS). Results. One hundred and forthteen patients with advanced stage lung cancer were recruited. Forty-three patients dropped out. No serious adverse events were reported. Exercise adherence in the group training was 68%. Improvements in VO2peak ( P < .001) and 6-minute walk distance ( P < .001) and muscle strength measurements ( P < .05) were seen. There was a reduction in anxiety level ( P = .0007) and improvement in the emotional well-being parameter (FACT-L) but no statistically significant changes in HRQoL were observed. Conclusion. The results of the present study show that during a 6-week hospital-based supervised, structured, and group-based exercise program, patients with advanced-stage lung cancer (NSCLC IIIb-IV, ED-SCLC) improve their physical capacity (VO2peak, 1RM), functional capacity, anxiety level, and emotional well-being, but not their overall HRQoL. A randomized controlled trial testing the intervention including 216 patients is currently being carried out.

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Section: Methodsmentioning

confidence: 99%

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confidence: 99%

The Impact of a Multidimensional Exercise Intervention on Physical and Functional Capacity, Anxiety, and Depression in Patients With Advanced-Stage Lung Cancer Undergoing Chemotherapy

et al. 2015

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“…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%

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

Avancini

Sartori

Gkountakos³

et al. 2019

The Oncologist

124

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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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“…In a similar study involving late-stage lung cancer patients, Temel et al [8] reported improvements in cardiovascular and muscular strength following an eight-week individualized exercise program. Finally, Kuehr et al [9] reported improved muscular strength and cardiorespiratory fitness following a supervised strength and cardiovascular exercise program.…”

Section: Exercise Across the Lung Cancer Spectrummentioning

confidence: 99%

The Effects and Efficacy of Exercise in Lung Cancer Patients: An Overview

O’Malley¹,

Stout²,

Ky³

2018

Health Sci J

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Lung cancer accounted for approximately 13% of new cancer cases, and over a quarter of all cancer-related deaths last year. This sample of literature supports the assertion that exercise has a positive impact on lung cancer prognosis. The multitude of factors affecting lung cancer patients, including cancer stage, treatment and secondary effects of cancer and treatment, indicate that a supervised, individualized program of exercise is most effective in working with lung cancer patients.

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Exercise in Patients with Non–Small Cell Lung Cancer

Cited by 73 publications

References 20 publications

The Impact of a Multidimensional Exercise Intervention on Physical and Functional Capacity, Anxiety, and Depression in Patients With Advanced-Stage Lung Cancer Undergoing Chemotherapy

The Impact of a Multidimensional Exercise Intervention on Physical and Functional Capacity, Anxiety, and Depression in Patients With Advanced-Stage Lung Cancer Undergoing Chemotherapy

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

The Effects and Efficacy of Exercise in Lung Cancer Patients: An Overview

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