A world-first clinical trial of a physical activity and self-management program for the management of lung cancer has been announced by the University of Melbourne school of Health Sciences in collaboration with the Victorian Comprehensive Cancer Centre.

Based on studies published in 2016 in the Journal of Physiotherapy and the Journal of Thoracic Oncology, the treatment will be focused on encouraging patients to increase their activity levels to build fitness and muscle strength both pre and post-surgery – an approach that has not been used as a standard in Australian oncology rehabilitation to date.

The trial combines physical activity and behavioural change strategies to assist lung cancer patients over an 18 month period. Using the guidelines of 150 minutes of moderate intensity physical activity and two to three resistance sessions per week, the participants will be encouraged to return to their daily activities as soon as possible after surgery.

In prehabilitation, exercise is delivered to patients prior to surgery or treatment to either improve the physical status of an inoperable patient to be well enough for operation; or as an attempt to prepare the body for the ‘physical assault’ of surgery in order to improve the recovery status of an operable patient.
Perioperative management strategies within the first three postoperative days include early mobilisation, sitting out of bed and supported coughing; and shoulder/thoracic cage exercises once the intercostal catheter is removed. The exercise treatment trial is due to commence at 5-7 weeks.

People with lung cancer can suffer from symptoms including fatigue, coughing and breathlessness, and their treatment options can present debilitating side effects such as gastro-intestinal complications. It is noted that physical activity during treatment for lung cancer is imperative for avoidance of functional decline, however such symptoms are often hard to overcome in order to maintain a suitable exercise regimen. Allied health support is limited in Australian treatment settings, which this trial hopes to address.

Not only has this research shown higher levels physical activity post-surgery shown better physical function in long-term survivors, it has also indicated better quality of life and mental health; however this has not been proven to be a causal relationship.

In researching the issue Dr Catherine Granger and her University of Melbourne team interviewed clinicians across the spectrum of care that patients would encounter, including physicians, surgeons, oncologists, nurses and physical therapists to determine potential barriers to treatment, patient motivations and opportunities for implementation.

The treatment is designed to be low-cost and available to regional and rural areas, with support given to the carers of lung cancer patients in order to improve the social support needed for treatment success.