“EXHALE”: exercise as a strategy for rehabilitation in advanced stage lung cancer patients: a randomized clinical trial comparing the effects of 12 weeks supervised exercise intervention versus usual care for advanced stage lung cancer patients

Morten Quist,Seppo W Langer,Lis Adamsen,Mikael Rørth,Karl Bang Christensen

doi:10.1186/1471-2407-13-477

Abstract

BackgroundLung cancer is the leading cause of cancer death in North America and Western Europe. Patients with lung cancer in general have reduced physical capacity, functional capacity, poor quality of life and increased levels of anxiety and depression. Intervention studies indicate that physical training can address these issues. However, there is a lack of decisive evidence regarding the effect of physical exercise in patients with advanced lung cancer. The aim of this study is to evaluate the effects of a twelve weeks, twice weekly program consisting of: supervised, structured training in a group of advanced lung cancer patients (cardiovascular and strength training, relaxation).Methods/DesignA randomized controlled trial will test the effects of the exercise intervention in 216 patients with advanced lung cancer (non-small cell lung cancer (NSCLC) stage IIIb - IV and small cell lung cancer (SCLC) extensive disease (ED)). Primary outcome is maximal oxygen uptake (VO2peak). Secondary outcomes are muscle strength (1RM), functional capacity (6MWD), lung capacity (Fev1) and patient reported outcome (including anxiety, depression (HADS) and quality of life (HRQOL)).DiscussionThe present randomized controlled study will provide data on the effectiveness of a supervised exercise intervention in patients receiving systemic therapy for advanced lung cancer. It is hoped that the intervention can improve physical capacity and functional level, during rehabilitation of cancer patients with complex symptom burden and help them to maintain independent function for as long as possible.Trial registrationhttp://ClinicalTrials.gov, NCT01881906

Highlights

Lung cancer is the leading cause of cancer death in North America and Western Europe
The results showed that lung cancer patients had more symptoms and side effects, increased anxiety and depression levels and impaired HRQOL compared to patients with 10 other cancer diagnoses [8]
The results showed no significant improvement in quality of life, anxiety or depression as measured by Functional Assessment of Cancer Therapy - Lung (FACT-L) and Hospital Anxiety and Depression scale (HAD)

Summary

Introduction

Lung cancer is the leading cause of cancer death in North America and Western Europe. Patients with lung cancer in general have reduced physical capacity, functional capacity, poor quality of life and increased levels of anxiety and depression. For patients with advanced lung cancer (NSCLC IIIb-IV SCLC ED), the median survival after diagnosis is 10–13 months [2]. Patients with lung cancer receiving chemotherapy often experience a range of treatment- and disease-related symptoms such as dyspnea, cough, pain, decreased appetite, decreased functional capacity, and fatigue [4]. The results showed that lung cancer patients had more symptoms and side effects, increased anxiety and depression levels and impaired HRQOL compared to patients with 10 other cancer diagnoses [8]. Incurable tumors, such as lung and pancreatic cancer, reported the heaviest symptom and side effect burden compared with other cancer diagnoses [9]

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Methods

Conclusion