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Lung Cancer and Exercise?

Studies show exercise in lung cancer patients can improve survival and quality of life. 

BY LACEY MEYER
PUBLISHED THURSDAY, MARCH 4, 2010
Talk about this article with other patients, caregivers, and advocates in the Lung CURE discussion group.
Regular exercise is one of the best things a person can do as a cancer patient or survivor, with studies showing improvements in cardiorespiratory fitness, quality of life, fatigue, and depression. However, very few studies have focused on the feasibility, safety, or efficacy of exercise in lung cancer patients. Is exercise safe for people with lung cancer? Is it beneficial? Is a long-term exercise program feasible? Yes. Yes. And yes, say experts. 

Over the past few years, researchers have produced small, but significant data showing exercise may also have important benefits for lung cancer patients and survivors, regardless of disease stage or limited physical activity, also called "de-conditioning," which can cause the heart and muscles to regress and become less efficient.

According to Lee Jones, PhD, scientific director of the Duke Center for Cancer Survivorship at Duke University School of Medicine, fitness levels in lung cancer patients are 30 to 40 percent below average healthy adults, in many cases related to long-term effects of smoking. However, exercise therapy can increase these fitness levels, whether it is performed before or after surgery.

Cardiorespiratory fitness—the capacity of the heart, lungs, and circulatory system to transport oxygen to the working skeletal muscles—is dependent on age and gender and varies based on the amount of exercise an individual performs on a regular basis.

In addition to improving cardiorespiratory fitness in lung cancer patients, research shows that exercise training is also associated with several positive patient-reported outcomes including improvements in fatigue, depression, sleep, quality of life, and breathlessness. And these benefits may extend across the board, Jones says, regardless of disease stage, treatment, or whether patients have received surgery or not.

“Fitness, believe it or not, is among one of the strongest predictors of how long you will live,” Jones says. “Your fitness level before surgery will predict your risk of surgical complications as well as following surgery. Now we have data suggesting that your fitness levels pre-surgery may also predict how long lung patients may live beyond traditional markers of longevity.”

As the lead investigator of a study published in the journal Cancer in 2007, Jones showed that four to six weeks of aerobic exercise, consisting of stationary cycling five times a week, before surgery improved fitness levels by 15 to 22 percent. However, the study only included 20 patients with lung cancer, most of whom had non-small cell lung cancer.

He led another study, published in Cancer in 2008, which included 19 NSCLC patients, showing that 14 weeks of exercise therapy (consisting of stationary cycling three times a week) after lung cancer surgery improved fitness levels by approximately 11 percent (a healthy person is expected to improve by 15 percent). While fitness levels of patients who exercised during chemotherapy did not improve, Jones says exercise may still be beneficial.

“We don’t know what happens to [patients’] fitness just getting chemotherapy without exercise training,” he says. “You probably assume that fitness would go down. So, even maintaining fitness across the course of chemotherapy might still be an important benefit for lung cancer patients.”

Talk about this article with other patients, caregivers, and advocates in the Lung CURE discussion group.
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