Physical Activity and Lung History Cancer Prevention Treatment By Derek Crowe Nina Pham What is Lung Cancer Lung cancer is a progression that starts off with an abnormal cell growth and overtime grows into a tumor Forms in one or both of the lungs and therefore one of the major complications it causes has to do with breathing It is the 1 cause of death from cancer Waynes M 2015 Deaths from lung cancer 160 000 deaths each year in the U S alone 1 4 million deaths worldwide The 5 year survival rate is one of the lowest at 17 There is a much greater risk of obtaining and dieing of lung cancer in smokers compared to non smokers Black men have the greatest risk of getting lung cancer followed by white men Women have a generally lower risk than men How Common is Lung Cancer 2016 Lung Cancer Facts Figures Factors 2011 Incidence of Lung Cancer in different regions of the U S by race ethnicity between 1998 2006 Racial Ethnic Disparities and Geographic Differences in Lung Cancer Incidence in 38 States and the District of Columbia 1998 2006 2010 Risk Factors of Lung Cancer Modifiable Smoking Smoking and secondhand smoke are 2 of the biggest risks for lung cancer the amount you smoke a day and time you have been smoking are what determines your risk Exposure to asbestos Asbestos especially in the workplace is also a very big risk factor especially when paired with smoking Non modifiable Family History If you have a family history of lung cancer you increase your risk Age of all lung cancer diagnoses occur in older people age 65 Lung Cancer Risk Factors 2015 Study Design and Population The Impact of Physical Activity on Fatigue and Quality of Life in Lung Cancer Patients Dhillon et al 2012 Randomized Control Trial Study Population Patients who had lung cancer recruited from lung cancer clinics at 4 different hospitals Had non resectable non curable lung cancer About 102 patients 18 years old or older male and female participated Medically fit Have had treatment with chemotherapy or radiotherapy for at least 4 weeks before the study How was PA fatigue QOL measured and Cancer measured The Impact of Physical Activity on Fatigue and Quality of Life in Lung Cancer Patients Dhillon et al 2012 PA questionnaire Also provided a pedometer to keep track of activity Fatigue was assessed by the functional assessment of cancer therapy Patient recorded outcome measures of how they are feeling QOL was assessed by QOL questionnaire Lung Cancer measured by oncologist People who were diagnosed with Stage 3 non small cell lung cancer and or limited small cell lung cancer People with advanced disease being treated palliatively may be receiving chemotherapy biological agents and or best supportive care Study Methods PA on Fatigue and QOL in Lung Cancer Patients Dhillon et al 2012 Patients were randomized into 2 groups 2 month PA generalized health care education and 8 weeks of PA program Usual care were provided general health care education Patients in PA group Supervised aerobic PA 30 45 mins and behavioral support sessions to enhance unsupervised PA 15 30 min 1x week Both groups had follow ups every 2 4 6 months on physical fitness and function Also had a follow up on survival to death or 3 years of post intervention Main Findings The Impact of Physical Activity on Fatigue and Quality of Life in Lung Cancer Patients Dhillon et al 2012 Evidence that PA programs improve cancer fatigue and QOL in cancer population with high symptoms of lung cancer Advanced lung cancer is incurable but the goal of the PA treatment improved QOL and maintaining physical function PA programs most effective in the early stages of lung cancer The PA intervention has potential to improve standard care in a simple fast inexpensive way Impact of PA on symptoms of lung cancer survivors Study Design Population Lin Y Rau K Lin C 2015 Longitudinal Study Study Population Patients were 18 years older males and females Average age 68 76 years 185 patients participated 143 continued participation until the second assessment time point 21 participants lost due to 6 deaths or 15 personal reasons emotional stress or lack of motivation Final sample 122 patients total Impact of PA on symptoms of lung cancer survivors Study Methods Lin Y Rau K Lin C 2015 Participants took different questionnaires to measure their PA and symptoms 3 different assessment points after the patients were enrolled in the study They did the questionnaires initial in the beginning of the study Two follow ups after in increments of 3 months for a total of 3 month questionnaire and 6 month questionnaire Took 10 mins to complete each questionnaire Impact of PA on symptoms of lung cancer survivors How PA and Cancer were measured Lin Y Rau K Lin C 2015 Godin Leisure Time Exercise Questionnaire measured PA behaviors Determines the average frequency and duration patient engages in PA over a typical week of their leisure time with minimal effort moderate not exhausting strenuous rapid heartbeat Cancer in patients Initially enrolled lung cancer survivors treated through surgery at medical center in Taiwan Diagnosed with lung cancer by primary physician Had treatment with surgery chemotherapy radiation therapy or targeted therapy Had no evidence of a recurrent or progressive disease Impact of PA on symptoms of lung cancer survivors How symptoms were measured Lin Y Rau K Lin C 2015 Taiwanese version of the Doctor of Medicine Anderson Symptom Inventory Measured severity of symptoms Part 1 and the degree at which the symptoms interfered with daily living Part 2 Part 1 Different items such as fatigue disturbed sleep pain drowsiness lack of appetite nausea vomiting shortness of breath numbness difficulty remembering dry mouth distress emotional and sadness were used to get a total number of symptoms intensity Items are rated on a scale of 0 not present and 10 as bad as you can imagine Part 2 assesses the extent to which symptoms interfere with general activities mood normal work relations with other people walking ability and enjoyment of life Items is rated on a scale of 0 no interference to 10 interferes completely Impact of PA on symptoms of lung cancer survivors Main Findings Lin Y Rau K Lin C 2015 Sleep disorders are persistent primary symptom of lung cancer survivors Engaging in mild PA makes symptom interference less severe in lung cancer patients Moderate PA alleviates severity of overall symptoms Lung cancer survivors can enhance and maintain their health by engaging in physical