Increasing Physical Activity and Exercise in Lung Cancer: Reviewing Safety, Benefits, and Application

Abstract

Lung cancer continues to be a difficult disease frequently diagnosed in late stages with a high mortality and symptom burden. In part because of frequent lung comorbidity, even lung cancer survivors often remain symptomatic and functionally limited. Though targeted therapy continues to increase treatment options for advanced-stage disease, symptom burden remains high with few therapeutic options. In the last several decades, exercise and physical activity have arisen as therapeutic options for obstructive lung disease and lung cancer. To date, exercise has been shown to reduce symptoms, increase exercise tolerance, improve quality of life, and potentially reduce length of stay and postoperative complications. Multiple small trials have been performed in perioperative non-small-cell lung cancer patients, although fewer studies are available for patients with advanced-stage disease. Despite the increased interest in this subject over the last few years, a validated exercise regimen has not been established for perioperative or advanced-stage disease. Clinicians underutilize exercise and pulmonary rehabilitation as a therapy, in part because of the lack of evidence-based consensus as to how and when to implement increasing physical activity. This review summarizes the existing evidence on exercise in lung cancer patients.

Impact of prehabilitation on morbidity and mortality after pulmonary lobectomy by minimally invasive surgery: a cohort study

“…and disability related to sedentary lifestyles (35). Other authors found that rehabilitation is feasible, safe and can even prevent deterioration of the general condition in lung cancer patients (20).…”

“…The median number of days between CPET and surgery was 44 [29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46]. There was no significant difference between the two groups ( Table 2).…”

An international review and meta-analysis of prehabilitation compared to usual care for cancer patients

“…Physical activity and exercise are beneficial in terms of the primary and secondary prevention of cancer as well as cancer-related and all-cause mortality [36]. Future research should investigate the degree to which prehabilitation exercise programmes as an adjunct to traditional cancer therapies present an advantage for patients in terms of survival and recurrence.…”

Novel Therapies for Myelofibrosis

“…Physical activity during cancer treatment has been shown to improve various quality of life measures (108, 109). These benefits are likely generalizable to hematologic malignancies including MPNs (110).…”