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C. Michaels
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ED 12 - Caring for the Lung Cancer Patient (ID 12)
- Event: WCLC 2015
- Type: Education Session
- Track: Nursing and Allied Professionals
- Presentations: 1
- Moderators:A. Fraser, M. Turner
- Coordinates: 9/09/2015, 14:15 - 15:45, 108+110+112
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ED12.06 - Importance of Exercise in Lung Cancer Treatment (ID 1823)
14:20 - 14:33 | Author(s): C. Michaels
- Abstract
- Presentation
Abstract:
Lung cancer survivors may suffer difficulty breathing, coughing, fatigue, anxiety, depression, insomnia and pain. Lung cancer survivors often experience a reduced quality of life. The good news is that quality of life can be improved with exercise and it should be considered for every patient. Exercise reduces the risk of lung cancer and is associated with reduced mortality. Exercise also lessens adverse symptoms and may improve quality of life, by enhancing physical and social function and lessening fatigue. The following are three of the more recent studies that have examined the benefits of exercise for lung cancer patients: 1. A 2012 study from Denmark looked at 25 patients with stage III/IV non-small cell cancer, and four patients with extensive disease small cell lung cancer. They participated in a 6-week supervised structured exercise and relaxation-training program. The researchers found that of the 23 patients, who completed the program, the majority adhered to the program and there were significant improvements in VO2 peak and 6-minute walking distance, as well as in muscle strength. The patients also reported a significant improvement in emotional well being. 2. In 2014, a larger study in Germany, included 40 patients with predominantly advanced NSCLC, who were receiving simultaneous or sequential radio chemotherapy or chemotherapy alone. The authors concluded, “ In this pilot study, endurance and strength capacity improved over time, indicating the rehabilitative importance of the applied intervention.” 3. In 2015, Dr. Gerard Silvestri, Dr. Brett Bade, David Thomas, and JoAnn Scott at the Medical University of South Carolina researched the benefit of physical activity and exercise for lung cancer patients. Their results were published in the Journal of Thoracic Oncology, June 2015. They found that physical activity should be considered as a therapeutic option for patients with lung cancer. They also concluded that exercise is safe, reduces symptoms, improves quality of life, increases exercise tolerance, and decreases length of hospitalization and post-surgery complications for lung cancer. Additionally, health care professionals should recommend exercise and encourage physical activity in patients at any stage of lung cancer. We can conclude from these studies and from my experience of working with this population that lung cancer survivors benefit from cancer exercise programs. These programs teach survivors how to exercise properly, and provide an exercise schedule. They can also provide a social and educational forum. Lung cancer patients may see even the idea of exercising as overwhelming, particularly if they suffer from shortness of breath, coughing or fatigue.The Medical University of South Carolina study found that patients with lung cancer want advice about physical activity from a cancer center physician before, during and following cancer therapy. The researchers also found that, when patients received this type of advice, there was a greater likelihood that the patients would comply with an exercise program. Why exercise during and after treatment or surgery? Exercise is a safe and inexpensive cancer therapy that reduces symptoms and improves quality of life. It improves strength, endurance, pulmonary function and flexibility, decreases the side effects of treatment and post-operative complications. Inactivity in cancer patients is associated with poorer outcomes and can cause the heart and muscles to regress and become less efficient. Being physically active not only helps prevent lung cancer in the first place, but it appears to also improve survival and quality of life for those already diagnosed. How much and what type of exercise is needed? The goal is to be able to exercise every day with a total of 150 minutes a week, the same as a healthy person. Lung cancer survivors should progress slowly, set goals, and listen to their bodies. Exercises can be performed initially in small increments of 10 minutes at a time depending on the fatigue level. Aerobic exercise is a great way to improve fitness. It not only improves cardiac function, but also improves the oxygen capacity. Aerobic exercises include walking, dancing, or any activity that increase the heart rate. Participate in enjoyable low intensity activities. Low intensity exercise such as walking is a safe way to begin. Aerobic exercise can be performed at a time that is convenient and there is no need to belong to an expensive gym. You can start by walking around a room in the house and slowly increase the distance walked. This can be done several times a day. You can use a pedometer to measure your steps and to help you set and attain goals. When sedentary one loses strength and gets weaker. Try to add movement to your day. You can take the stairs, park far from your destination, dance or whatever you enjoy that involves movement. Lung cancer patients may also benefit from strength training because it can strengthen weakened muscles. Fatigue can lead to sedentary behavior. Muscle mass will decrease if you sit or lie in bed a lot. By getting stronger it may be possible to return to work and take care of activities of daily living. Strength training can help you to improve balance, posture and increase bone strength. Patients with shortness of breath due to their cancer should perform stretching exercises daily to increase lung capacity. These can help to keep chest muscles loose and encourage deep breathing. Stretching can also help improve posture. Sitting down all day at a desk or driving can cause rounded shoulders and kyphosis, which can decrease lung capacity. It is also good to exercise prior to surgery and treatments and for those who are not surgical candidates. Exercise before surgery has multiple benefits such as improved quality of life, pulmonary capacity, endurance and strength coupled with reduced fatigue and surgical complications. Fitness level before surgery may predict risks of surgical complications and pre-surgery fitness levels may also predict how long lung patients may live beyond traditional markers of longevity. Despite limited lung capacity, exercise can help patients with lung cancer improve their quality of life by reducing fatigue, adverse symptoms and depression, while improving muscle strength, flexibility and mood.
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