Impact of self-reported physical activity and health promotion behaviors on lung cancer survivorship

Abstract

BackgroundThere is some initial evidence that an enhanced physical activity level can improve fquality of life, and possibly survival among patients with lung cancer. The primary aim of this project was to evaluate the impact of physical activity on the quality and quantity of life of lung cancer survivors.MethodsBetween January 1, 1997, and December 31, 2009, a total of 1466 lung cancer survivors completed a questionnaire with patient-reported outcomes for quality of life (QOL), demographics, disease and clinical characteristics, and a measure of physical activity (Baecke Questionnaire). Chi-square tests compared lung cancer survivors who reported being physically active versus not on a variety of the other covariates. Kaplan-Meier estimates and Cox models evaluated the prognostic importance of physical activity level on Overall Survival (OS).ResultsRoughly half of the lung cancer survivors had advanced stage disease at the time of survey. Treatment prevalence rates were 61, 54, and 33 % for surgery, chemotherapy and radiotherapy, respectively. The majority (77 %) of survivors reported themselves as physically active. Physically active survivors reported greater activity across all individual Baecke items. Lung cancer survivor-reported QOL indicated the benefits of physical activity in all domains. Survivors receiving chemotherapy or radiation at the time of questionnaire completion were less likely to be physically active (74 and 73 % respectively). In contrast, 84 % of surgical patients were physically active. Disease recurrence rates were the same for physically active and inactive patients (81 % vs 82 %, p = 0.62). Physically active patients survived an average of 4 more years than those who were not physically active (8.4 years versus 4.4 years respectively, log rank p < 0.0001).ConclusionsBeing physically active was related to profound advantages in QOL and survival in a large sample of lung cancer survivors.

<p>Feasibility and Utility of Incorporating Patient-Reported Outcomes into Surveillance Strategies for Advanced Lung Cancer</p>

“…39 Disease progression had a significant adverse impact on many PROs' endpoints; 40 PROs showed that they were useful in identifying patients with advanced NSCLC who are likely to have significantly lower survival. 41 The prognostic power of overall QoL on the survival of lung cancer patients and the advantages for lung cancer survivors reporting to be physically active was demonstrated versus those who were not physically active; 42 the early detection of symptomatic relapse and management of symptoms through a webmediated individualized follow-up strategy provided an improvement in quality of life and overall survival. 43 The third group included the studies that evaluated the agreement between the PROs and the evaluated parameters: concordance between LCSS and ECOG PS measurements and tumor-related symptoms is reported.…”

Exercise and cancer: a position statement from the Spanish Society of Medical Oncology

“…Data from a prospective observational study in kidney cancer survivors investigating PA and diet changes suggested a decrease in the recurrence rate in patients who did any PA compared with those that were totally inactive [118]. The only study in lung cancer survivors showed better overall survival in patients who met > 9 MET-hours/week, but no difference in the recurrence rate was observed [119].…”

An Evolving Role for Cancer Rehabilitation in the Era of Low‐Dose Lung Computed Tomography Screening

“…In the setting of brain metastases, whole‐brain radiation therapy is also a predictor for development of impaired mobility [24]. Of note, patients receiving chemotherapy and/or radiation therapy self‐report less physical activity compared to long‐term lung cancer survivors and those who have recently undergone surgery [33]. It is unclear whether earlier detection of disease through the use of LDCT would obviate the need for chemoradiation therapy.…”

“…Yang et al found that exercise improved HRQoL in 5‐year NSCLC survivors, despite the fact that symptom burden was not reduced [70]. In addition, self‐reported physical activity in lung cancer survivors improves physical, emotional, and mental well‐being, although it has no impact on disease recurrence [33].…”