Exercise as it relates to Disease/Exercise effects in lung cancer

Lung cancer is the most common cancer in the Western World and has very poor survival rate (only 10–15% of patients survive 5 years or longer).C.J Beadsmoore, N.J Screaton . Classification, staging and prognosis of lung cancer. European Journal of Radiology, Volume 45, Issue 1, January 2003, Pages 8–17 In Australia, it is the fifth most common cancer but is the most common cause of deaths due to cancer. It is estimated in year 2020, 13640 people would be diagnosed with lung cancer in Australia.http://canceraustralia.gov.au/affected-cancer/cancer-types/lung-cancer/lung-cancer-statistics Physical activity has shown significant improvements on the quality of life, physical function and physical capacity in patients with lung cancer.Morten Quist, Mikael Rorth, Seppo Langer, Lee W. Jones, Jorgen H. Laursen, Helle Pappot, Karl Bang Christensen, Lis Adamsen .Safety and feasibility of a combined exercise intervention for inoperable lung cancer patients undergoing chemotherapy. Lung Cancer, Volume 75, Issue 1, January 2012, Pages 126–132 What is lung Cancer? Lung cancer is uncontrolled epithelial cell growth within the lung tissues and airways of lungs.Alan J Neville, Mridula Sara Kuruvilla. Lung cancer. Clin Evid (Online) 2010; 2010: 1504. Published online 2010 November 30. Page2 It can originate from any part of the lungs, including the trachea, bronchi, bronchioles and alveoli.Lung cancer in Australia page 1-2 http://www.aihw.gov.au/publication-detail/?id=10737420419 There are two main types of lung cancers non-small cell carcinoma (about 80% of all lung cancers) small cell carcinoma (about 20% of all lung cancers) Etiology of lung cancer Tobacco smoking is the main cause which accounts for 80 to 90% of all cases.Stephen S. Hecht. Tobacco Smoke Carcinogens and Lung Cancer. JNCI J Natl Cancer Inst (1999) 91 (14): 1194-1210. Environmental factors such as exposure to radon, diesel air pollutants, asbestos, chromium and uranium Samet , Jonathan M. Environmental Causes of Lung Cancer. CHEST, May, 2004 Supplement, Vol. 125, p 80S-83S. Family history of lung cancer and previous lung disease.http://canceraustralia.gov.au/affected-cancer/cancer-types/lung-cancer Symptoms and treatment of lung cancer Majority of adults with lung cancer are symptomatic when they are diagnosed and exhibit following symptoms:Linda H. Yoder. An Overview of Lung Cancer Symptoms, Pathophysiology, And Treatment. MEDSURG Nursing, August 2006, Vol. 15, No. 4 Cough * Dyspnoea * Hoarseness* Chest pain* Wheezing* Haemoptysis* Nausea/Vomiting* Swelling of face and arm * Anorexia Weight Loss * Fatigue* Bone pain* Clubbing* Headache* Seizures. Treatment of lung cancer depends upon the type and stage of the cancer, and includeshttp://www.merckmanuals.com/professional/pulmonary_disorders/tumors_of_the_lungs/lung_carcinoma.html?qt=&sc=&altSharon Parmet, Cassio Lymn, Richard M. Lung Cancer. JAMA, August 24/31, 2005, Vol 294, No. 8# Radiotherapy # Surgery # Chemotherapy # Targeted therapy. Treatment methods have variety of associated side effects e.g. Cancer therapy has negative effects on cardiovascular system which leads to higher mortality in cancer patients.Robert U. Newton, Daniel A. Galvao.Exercise in Prevention and Management of Cancer. Current Treatment Options in Oncology (2008) 9:135–146 Benefits of Exercise in Lung Cancer Various studies have shown that exercise has beneficial effects on patients with lungs cancers and benefits include Andersen, Andreas H. Vinther, Anders Poulsen, Lise-Lotte Mellemgaard, Anders. Do patients with lung cancer benefit from physical exercise. Acta Oncologica, Feb 2011, Vol. 50 Issue 2, p307-313.Amy J. Litterini, Diane U. Jette. Exercise for Managing Cancer-Related Fatigue. Physical Therapy Journal of American Physical Therapy Association, Mar2011, Vol. 91 Issue 3, p301 4pChueh-Lung Hwang, Chong-Jen Yu, Jin-Yuan Shih, Pan-Chyr Yang, Ying-Tai Wu. Effects of exercise training on exercise capacity in patients with non-small cell lung cancer receiving targeted therapy. Supportive Care in Cancer, December 2012, Volume 20, Issue 12, pp 3169-3177.Lee W Jones, Neil D Eves, William E Kraus, Anil Potti, Jeffrey Crawford, James A Blumenthal, Bercedis L Peterson and Pamela S Douglas. The lung cancer exercise training study: a randomized trial of aerobic training, resistance training, or both in postsurgical lung cancer patients: rationale and design. http://www.biomedcentral.com/1471-2407/10/155 Improves physical fitness and quality of life Improves cardio respiratory fitness by increasing VO2 peak Enhances both maximum aerobic capacity and walking distance May also diminish side-effects of chemotherapy and radiation therapy Improves the psychological stress connected with cancer and its treatment, improves mood and reduce anxiety May decrease fatigue pre- and post-operatively An important component of cancer rehabilitation Exercise Recommendations http://sportsmedicine.about.com/cs/injuryprevention/a/aa071001a.htmC. F. van Uden-Kraan, M. J. M Chinapaw, C. H. C. Drossaert, I. M. Verdonck-de Leeuw, L. M. Buffart. Cancer patients experiences with and perceived outcomes of yoga: results from focus groups. Supportive Care in Cancer, July 2013, Volume 21, Issue 7, pp 1861-1870. Exercise Program Duration (min/session) Intensity (% of VO2peak) Aims Warm up Exercises for upper and lower limbs like stationary cycling, treadmill 10 min Low to moderate intensity Enhances speed and strength in muscles Aerobic training • Circuit training • Walking training • Cycling ergometry 20–60 min 3-5 sessions / week 55% to 90%VO2peak Improves cardio-respiratory fitness Strength training Leg press, chest press, lateral machine, leg extension, abdominal crunch, and lower back 20–60 min 3-5 sessions / week 60-80% of 8-10 sets rep. max Improves skeletal muscle function and cardio-respiratory function Stretching For large muscles 25-45 min 3 sessions/ week Duration of each stretch 5 min Increase agility and flexibilityYoga Mind and body relaxation by improving respiration 15-20 min 2-3 times /week - Improves fatigue, distress, and general quality of life Note: Breathing exercises such as diaphragmatic breathing, pursed lip breathing are helpful in improving breathlessness. Positioning of patient is also an important component during breathing exercises.Cairns, Lindsay. Managing breathlessness in patients with lung cancer. Nursing Standard (NURS STAND), 2012 Nov 27; 27 (13): 44-9. (48 ref) Consideration Perceived barriers to exercise Margaret Joyce, Sue Schwartz, Maureen Huhmann. Supportive Care in Lung Cancer. Seminars in Oncology Nursing, Volume 24, Issue 1, February 2008, Pages 57–67Angel López-Encuentra. Comorbidity in operable lung cancer: A multicenter descriptive study on 2992 patients. Lung Cancer Volume 35, Issue 3, March 2002, Pages 263–269 Age: average age of LC patients at the time of diagnosis is high (above 60years) Co-morbidities: COPD, arterial hypertension, cardiac disease, peripheral vascular disease, previous tumours and diabetes LC symptoms: fatigue, dyspnea, anorexia and pain Emotional well being: depression, anxiety, lowered self esteem and loss of sense of control Strategies to improve exercise participation and adherence Carla Ida Ripamonti. Early supportive care for lung cancer patients. Lung Cancer, Volume 77, Supplement 1, June 2012, Pages S18–S19M L Irwin. Physical activity interventions for cancer survivors. British Journal of Sports Medicine, 2009, 43: 32-38 Exercise programs tailored according to patient’s condition Management of cancer symptoms and treatment complications Psychological and social counseling Educational and motivational sessions Physical activity integrated into cancer treatment plan Encouraging Oncologist to prescribe physical activity Further reading Physical activity reducing risk of Lung Cancer Physical Activity, Diet And Lung Cancer References