" 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
Quist M.,Copenhagen University |
Quist M.,Center for Integrated Rehabilitation of Cancer Patients |
Langer S.W.,Center for Integrated Rehabilitation of Cancer Patients |
Langer S.W.,Copenhagen University |
And 6 more authors.
BMC Cancer | Year: 2013
Background: 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. 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/Design: A 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)).Discussion: The 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 registration: http://ClinicalTrials.gov, NCT01881906. © 2013 Quist et al.; licensee BioMed Central Ltd.
Missel M.,Copenhagen University |
Pedersen J.H.,Copenhagen University |
Hendriksen C.,Copenhagen University |
Tewes M.,Copenhagen University |
Adamsen L.,Center for Integrated Rehabilitation of Cancer Patients
Supportive Care in Cancer | Year: 2015
Purpose: The purpose was to explore operable lung cancer patient experiences with an exercise intervention from a longitudinal perspective according to patient motivation and patient perceived benefits and barriers of exercise. Methods: Nineteen patients enrolled in an exercise intervention 2 weeks post-surgery participated in qualitative interviews at three time points. A criteria sampling strategy was applied. Ricoeur’s phenomenological hermeneutical philosophy inspired the analysis. Results: Patients initiated exercising median 15 days postoperative. Eight patients included in the interview study dropped out of the intervention due to side effects of chemotherapy (n = 3) and external circumstances (n = 5). The mean attendance rate for the eleven participants who completed the intervention was 82 %. No patients experienced severe adverse events. Motivation for participation included patients’ expectations of physical benefits and the security of having professionals present. Patients experienced physical and emotional benefits and affirmed their social identity. Barriers were primarily related to side effects of chemotherapy. Conclusion: The exercise intervention was undertaken safely by operable lung cancer patients initiated 2 weeks after surgery. The intervention put the patients on track to a healthier lifestyle regarding physical activity and smoking. The study indicates that exercise initiated early in the treatment trajectory is beneficial for operable lung cancer patients and especially for those who were physically active and motivated pre-illness and who did not experience side effect of treatment. © 2015, Springer-Verlag Berlin Heidelberg.
Jarden M.,Copenhagen University |
Jarden M.,Center for Integrated Rehabilitation of Cancer Patients |
Moller T.,Copenhagen University |
Moller T.,Center for Integrated Rehabilitation of Cancer Patients |
And 14 more authors.
BMC Cancer | Year: 2013
Background: Patients with acute leukemia experience a substantial symptom burden and are at risk of developing infections throughout the course of repeated cycles of intensive chemotherapy. Physical activity in recent years has been a strategy for rehabilitation in cancer patients to remedy disease and treatment related symptoms and side effects. To date, there are no clinical practice exercise guidelines for patients with acute leukemia undergoing induction and consolidation chemotherapy. A randomized controlled trial is needed to determine if patients with acute leukemia can benefit by a structured and supervised counseling and exercise program.Methods/design: This paper presents the study protocol: Patient Activation through Counseling and Exercise - Acute Leukemia (PACE-AL) trial, a two center, randomized controlled trial of 70 patients with acute leukemia (35 patients/study arm) following induction chemotherapy in the outpatient setting. Eligible patients will be randomized to usual care or to the 12 week exercise and counseling program. The intervention includes 3 hours + 30 minutes per week of supervised and structured aerobic training (moderate to high intensity 70 - 80%) on an ergometer cycle, strength exercises using hand weights and relaxation exercise. Individual health counseling sessions include a self directed home walk program with a step counter. The primary endpoint is functional performance/exercise capacity (6 minute walk distance). The secondary endpoints are submaximal VO2 max test, sit to stand and bicep curl test, physical activity levels, patient reported outcomes (quality of life, anxiety and depression, symptom prevalence, intensity and interference). Evaluation of clinical outcomes will be explored including incidence of infection, hospitalization days, body mass index, time to recurrence and survival. Qualitative exploration of patients' health behavior and experiences.Discussion: PACE-AL will provide evidence of the effect of exercise and health promotion counseling on functional and physical capacity, the symptom burden and quality of life in patients with acute leukemia during out patient management. The results will inform clinical practice exercise guidelines and rehabilitation programs for patients undergoing treatment for acute leukemia. Optimizing the treatment and care pathway may ease the transition for patients from illness to the resumption of everyday activities.Trial registration: ClinicalTrials.gov Identifier: NCT01404520. © 2013 Jarden et al.; licensee BioMed Central Ltd.