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Cardiopulmonary rehabilitation after treatment for lung cancer

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Opinion statement

Lung cancer is the leading cause of cancer-related death in women and men in the United States. As of 1987, lung cancer deaths in women exceeded deaths caused by breast cancer. Despite years of research and improvements in surgical, chemotherapeutic, and radiation treatments, this fact remains unchanged. Equally dismal is that the expected 5-year survival rate for all patients with lung cancer is 15%. Although hidden in this number is improved survival for many patients who have early disease, it still translates into significant morbidity and early mortality for many patients. Although prevention is key, optimizing the care of these patients with lung cancer is also paramount. Cardiopulmonary rehabilitation programs have been shown to be effective in treating patients with chronic heart and lung diseases, among other illnesses, regardless of prerehabilitation functioning. Not only do morbidity and mortality from cancer hinge directly on premorbid functioning, health, and status, but functional status as a measure of baseline health is a reliable prognostic indicator for patients with lung cancer. As a result, including a program of exercise in any treatment regimen for cancer is sensible. However, rehabilitation in patients with lung cancer has not been studied well. Data on rehabilitation in patients with other cancers and illnesses (eg, chronic obstructive pulmonary disease) are clear in the beneficial effects of supervised exercise on quality of life (QOL). To assess the role of cardiopulmonary rehabilitation in patients with lung cancer undergoing treatment, it is necessary to meld studies regarding patients with noncancerous conditions with studies addressing rehabilitation in patients with cancer. This fusion of information demonstrates that rehabilitation results in significant improvements in QOL in patients who participate, regardless of the disease in question. Although QOL may not always have been an obvious endpoint for treating patients with lung cancer, it is apparent from studies of the patients themselves that an improved QOL is far more important than other goals of therapy.

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References and Recommended Reading

  1. American College of Chest Physicians; Health and Science Policy Committee: Diagnosis and management of lung cancer: ACCP evidence-based guidelines. Chest 2003, 123(Suppl 1):1S-337S.

    Google Scholar 

  2. Dimeo FC, Stieglitz RD, Novelli-Fischer U, et al.: Effects of physical activity on the fatigue and psychologic status of cancer patients during chemotherapy. Cancer 1999, 85:2273–2277. This paper is another cornerstone regarding the rehabilitation of patients with lung cancer.

    Article  PubMed  CAS  Google Scholar 

  3. Colice GL, Rubins J, Unger M, et al.: Follow-up and surveillance of the lung cancer patient following curative intent therapy. Chest 2003, 123(Suppl 1):272S-283S.

    Article  PubMed  Google Scholar 

  4. Balady GJ, Ades PA, Comoss P, et al.: Core components of cardiac rehabilitation/secondary prevention programs: a statement for healthcare professionals from the American Heart Association and the American Association of Cardiovascular and Pulmonary Rehabilitation Writing Group. Circulation 2000, 102:1069–1073.

    PubMed  CAS  Google Scholar 

  5. Dimeo FC, Tilmann MH, Bertz H, et al.: Aerobic exercise in the rehabilitation of cancer patients after high dose chemotherapy and autologous peripheral stem cell transplantation. Cancer 1997, 79:1717–1722. This is an important paper that focuses on the issue of rehabilitation of patients receiving therapy for cancer.

    Article  PubMed  CAS  Google Scholar 

  6. Ketelaars CA, Abu-Saad HH, Schlosser MA, et al.: Longterm outcome of pulmonary rehabilitation in patients with COPD. Chest 1997, 112:363–369.

    PubMed  CAS  Google Scholar 

  7. Winningham ML: Strategies for managing cancerrelated fatigue syndrome: a rehabilitation approach. Cancer 2001, 92(Suppl 4):988–997. By my review of the literature, this is the definitive paper regarding CRFS.

    Article  PubMed  CAS  Google Scholar 

  8. MacVicar MG, Winningham ML, Nickel JL: Effects of aerobic interval training on cancer patients’ functional capacity. Nurs Res 1989, 38:348–351. This paper and the paper by Dimeo et al. [5] are the basis for research in this area.

    Article  PubMed  CAS  Google Scholar 

  9. Nugent AM, Steele IC, Carragher AM, et al.: Effect of thoracotomy and lung resection on exercise capacity in patients with lung cancer. Thorax 1999, 54:334–338.

    Article  PubMed  CAS  Google Scholar 

  10. Algar FJ, Alvarez A, Salvatierra A, et al.: Predicting pulmonary complications after pneumonectomy for lung cancer. Eur J Cardiothorac Surg 2003, 23:201–208.

    Article  PubMed  Google Scholar 

  11. Weiner P, Man A, Weiner M, et al.: The effect of incentive spirometry and inspiratory muscle training on pulmonary function after lung resection. J Thorac Cardiovasc Surg 1997, 113:552–557.

    Article  PubMed  CAS  Google Scholar 

  12. Olders H, Winningham ML: Select psychiatric and psychological considerations. In Fatigue in Cancer: a Multidimensional Approach. Edited by Winningham ML, Barton-Burke M. Sudbury: Jones and Bartlett; 2000:197–242.

    Google Scholar 

  13. Normandin E, McCusker C, Connors M, et al.: An evaluation of two approaches to exercise conditioning in pulmonary rehabilitation. Chest 2002, 121:1085–1091.

    Article  PubMed  Google Scholar 

  14. Eisner MD, Yelin EH, Trupin L, Blanc PD: The influence of chronic respiratory conditions on health status and work disability. Am J Public Health 2002, 92:1506–1513.

    Article  PubMed  Google Scholar 

  15. Guell R, Casan P, Belda J, et al.: Long-term effects of outpatient rehabilitation of COPD: a randomized trial. Chest 2000, 117:976–983.

    Article  PubMed  CAS  Google Scholar 

  16. Berry MJ, Rejeski WJ, Adair NE, Zaccaro D: Exercise rehabilitation and chronic obstructive pulmonary disease stage. Am J Respir Crit Care Med 1999, 160:1248–1253.

    PubMed  CAS  Google Scholar 

  17. Niederman MS, Clemente PH, Fein AM, et al.: Benefits of a multidisciplinary pulmonary rehabilitation program: improvements are independent of lung function. Chest 1991, 99:798–804.

    PubMed  CAS  Google Scholar 

  18. Maltais F, LeBlanc P, Jobin J, et al.: Intensity of training and physiologic adaptation in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med 1997, 155:555–561.

    PubMed  CAS  Google Scholar 

  19. Wijkstra PJ, Van Altena R, Kraan J, et al.: Quality of life in patients with chronic obstructive pulmonary disease improves after rehabilitation at home. Eur Respir J 1994, 7:269–273.

    Article  PubMed  CAS  Google Scholar 

  20. Kosmidis P: Quality of life as a new end point. Chest 1996, 109:110S-112S.

    Google Scholar 

  21. Montazeri A, Gillis CR, McEwen J: Quality of life in patients with lung cancer: a review of the literature from 1970 to 1995. Chest 1998, 113:467–481. This is an important review of QOL, but it also discusses the rehabilitation issues.

    PubMed  CAS  Google Scholar 

  22. Eton DT, Fairclough DL, Cella D, et al.: Early change in patient-reported health during lung cancer chemotherapy predicts clinical outcomes beyond those predicted by baseline report: results from Eastern Cooperative Oncology Group Study 5592. J Clin Oncol 2003, 21:1536–1543.

    Article  PubMed  Google Scholar 

  23. Ruckdeschel JC, Piantadosi S: Quality of life in lung cancer surgical adjuvant trials. Chest 1994, 106(Suppl 6):324S-328S.

    PubMed  CAS  Google Scholar 

  24. Handy JR Jr, Asaph JW, Skokan L, et al.: What happens to patients undergoing lung cancer surgery? Outcomes and quality of life before and after surgery. Chest 2002, 122:21–30.

    Article  PubMed  Google Scholar 

  25. Sarna L, Padilla G, Holmes C, et al.: Quality of life of long-term survivors of non-small cell lung cancer. J Clin Oncol 2003, 20:2920–2929.

    Article  Google Scholar 

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  1. Pulmonary and Critical Care Medicine, University of Maryland School of Medicine, 601 South Charles Street, 21230, Baltimore, MD, USA

    Jeanette Nazarian MD

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  1. Jeanette Nazarian MD
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Nazarian, J. Cardiopulmonary rehabilitation after treatment for lung cancer. Curr. Treat. Options in Oncol. 5, 75–82 (2004). https://doi.org/10.1007/s11864-004-0008-4

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