Feasibility of a multimodal exercise, nutrition, and palliative care intervention in advanced lung cancer

Abstract

Background Advanced lung cancer patients face significant physical and psychological burden leading to reduced physical function and quality of life. Separately, physical activity, nutrition, and palliative symptom management interventions have been shown to improve functioning in this population, however no study has combined all three in a multimodal intervention. Therefore, we assessed the feasibility of a multimodal physical activity, nutrition, and palliative symptom management intervention in advanced lung cancer. Methods Participants received an individually tailored 12-week intervention featuring in-person group-based exercise classes, at-home physical activity prescription, behaviour change education, and nutrition and palliative care consultations. Patients reported symptom burden, energy, and fatigue before and after each class. At baseline and post-intervention, symptom burden, quality of life, fatigue, physical activity, dietary intake, and physical function were assessed. Post-intervention interviews examined participant perspectives. Results The multimodal program was feasible, with 44% (10/23) recruitment, 75% (75/100) class attendance, 89% (8/9) nutrition and palliative consult attendance, and 85% (17/20) assessment completion. Of ten participants, 70% (7/10) completed the post-intervention follow-up. Participants perceived the intervention as feasible and valuable. Physical activity, symptom burden, and quality of life were maintained, while tiredness decreased significantly. Exercise classes prompted acute clinically meaningful reductions in fatigue, tiredness, depression, pain, and increases in energy and well-being. Conclusion A multimodal physical activity, nutrition, and palliative symptom management intervention is feasible and shows potential benefits on quality of life that warrant further investigation in a larger cohort trial. Trial registration NCT04575831, Registered 05 October 2020 – Retrospectively registered.

Distress among cancer patients attending rehabilitation in the community

“…Besides exercise, stress management delivered through various intervention strategies such as cognitive behavioral therapy, mindfulness practice, deep breathing, and relaxation training has demonstrated positive effects on emotional well-being, pain, and fatigue [46,[53][54][55]. To effectively manage distressrelated symptoms, multimodal interventions that combine strategies such as exercise, stress management, nutrition, and psychoeducation have evidenced promising results with significant symptom reduction across diverse symptom clusters [56,57].…”

Deep Q-networks with web-based survey data for simulating lung cancer intervention prediction and assessment in the elderly: a quantitative study

“…Although previous researches of lung cancer intervention mainly focused on patients with diagnosed lung cancer [ 30 , 31 ] or advanced lung cancer patients [ 9 , 32 ], our study targeted to high risk elderly who had not developed lung cancer, which would be more conducive to prevent and control lung cancer. Junga investigated the exercise interventions in patients with lung cancer during chemotherapy regarding physiological and psychological outcomes [ 30 ].…”

“…lung cancer screening [ 6 – 8 ], and reduce lung cancer mortality, e.g. intervention for people with lung cancer [ 9 – 11 ]. The Lung, Prostate, Colorectal, and Ovarian (PLCO) cancer screening trial used annual screening with chest radiograph to evaluate the effect on mortality for lung cancer screening [ 6 ].…”

“…Zahnd et al analyzed the utilization of computed tomography (CT) in lung cancer screening through Behavioral Risk Factor Surveillance System (BRFSS) [ 8 ]. Manuel and colleagues assessed the feasibility of a multimodal physical activity, nutrition and palliative symptom management intervention in advanced lung cancer [ 9 ]. Lung cancer screening and intervention might be important to help detect lung cancer early and reduce the mortality, but little was known about lung cancer intervention strategy associated with intervention effect for preventing lung cancer.…”

ACE-Neuro: A tailored exercise oncology program for neuro-oncology patients – Study protocol

“…All feasibility aspects of the triage clinic will be reported separately. All feasibility thresholds are based on feedback from the clinical team and other feasibility work in exercise oncology [ [25] , [26] , [27] , [28] ]. With the advanced nature of disease in neuro-oncology, patients often experience high symptom burden and intensive treatments.…”