Lung cancer is the most commonly diagnosed cancer in men and third most commonly diagnosed cancer in women. Specifically, in Australia, lung cancer is the leading cause of cancer death and the fourth most common cancer diagnosed in both men and women.

Dr Vinicius Cavalheri, Curtin University and Cancer Council WA Postdoctoral Fellow

Dr Vinicius Cavalheri, Curtin University and Cancer Council WA Postdoctoral Fellow

The treatment offering the best chance of cure for people with early stage non-small cell lung cancer is surgical tumour resection (with or without adjuvant chemotherapy). However, this treatment compounds the decrements in exercise capacity and quality of life that patients commonly have when diagnosed.

Our Cochrane systematic review updated the evidence about the effectiveness of exercise training after lung resection for non-small cell lung cancer to improve exercise capacity, quality of life, muscle strength, symptoms of breathlessness and fatigue, feelings of anxiety and depression, and lung function. Eight studies (from the UK, Denmark, Australia, Norway, Spain, Belgium and the Netherlands) on 450 participants were included.

Our results showed that people with non-small cell lung cancer who undertook 8-20 weeks of exercise training after lung resection had better exercise capacity (measured by both VO2peak and 6-minute walk distance) and strength in their leg muscles compared to those who did not exercise.

It was also demonstrated that those who exercised had better quality of life and less breathlessness. The effect of exercise training after lung resection on fatigue and lung function was uncertain and insufficient evidence was found for improvements in feelings of anxiety and depression.

The systematic review emphasised the importance of exercise training as part of the postoperative management of people with non-small cell lung cancer.

A survey conducted by the research team at Curtin University (published 2013), which described management of people with lung cancer across Australia and New Zealand, reported only a small proportion were referred to exercise training programs following lung resection.

This new review suggests that referrals to exercise programs should be considered for this population, including pulmonary rehabilitation programs run by physiotherapists, and exercise training programs (such as Cancer Council WA Life Now) run by exercise physiologists.

A list of pulmonary rehabilitation programs that accept referrals can be found at the Lung Foundation Australia webpage (link: https://lungfoundation.com.au/exercise-classes/). A list of exercise training classes run by exercise physiologists, as part of the Cancer Council WA Life Now program, that may accept referrals (eligibility criteria applies) can be found at the Cancer Council WA webpage (link: https://www.cancerwa.asn.au/patients/support-and-services/life-now/exercise-classes/).

Key messages

  • Lung cancer remains a leading cause of death in Australia
  • Exercise, post-surgery, can improve quality of life
  • Patients can be referred to exercise classes

Reference:

Cavalheri, V., Burtin, C., Formico, V., Nonoyama, M., Jenkins, S., Spruit, M. and Hill, K. (2019). Exercise training undertaken by people within 12 months of lung resection for non-small cell lung cancer. Cochrane Database of Systematic Reviews.

Questions? Contact the editor.

Author competing interests: Dr Cavalheri was the lead author of the Cochrane review described.

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