# Exercise as it relates to Disease/Resistance Training & Lung Cancer
### What is lung Cancer?

Lung cancer occurs when abnormal cells in one or both lungs grow in an uncontrolled way.
* Small cell carcinoma (around 12% of lung cancer) usually arises from epithelial cells that line the surface of the centrally located bronchi.
* Non-small cell carcinoma (over 60% of lung cancer) consists of a different group of cancers that tend to grow and spread more slowly than small cell carcinoma. It mainly affects cells lining the bronchi and smaller airways.
* Other types account for around 25% of lung cancer.

### What are the symptoms of lung cancer?

The symptoms of lung cancer can often be vague and can be similar to those of other conditions. Unexplained, persistent symptoms lasting more than three weeks can include:
* a new or changed cough
* coughing up blood
* a chest infection that won’t go away
* chest pain and/or shoulder pain
* shortness of breath
* hoarse voice
* weight loss or loss of appetite

### Prevalence

In 2010, lung cancer was the 5th most commonly diagnosed cancer in Australia (after prostate, bowel, breast and melanoma of the skin), accounting for 8.8 per cent of all new cancers in Australia, excluding non-melanoma skin cancer. In 2011, lung cancer was the most common cause of cancer death for men and women (8,114 deaths overall: 4,959 in men; 3,155 in women), accounting for 18.8 per cent of all cancer deaths.

## Resistance Training
### Background

Strength training is a type of physical exercise specializing in the use of resistance to induce muscular contraction which builds the strength, anaerobic endurance, and size of skeletal muscles.
When properly performed, strength training can provide significant functional benefits and improvement in overall health and well-being, including increased bone, muscle, tendon and ligament strength and toughness, improved joint function, reduced potential for injury, increased bone density, increased metabolism, improved cardiac function, and elevated HDL ("good") cholesterol.

## Resistance Training and Lung Cancer
### Benefits

* While improvements in the treatments for cancer have led to better prognosis, fatigue during treatment remains a concern. Several studies have demonstrated the benefits of resistance training during and after lung cancer treatment.
* Patients with lung cancer are routinely treated with different treatments such as surgery, chemotherapy, and radiation. These treatments can cause functional ability to decline due to fatigue, and loss of lean muscle mass.
* Cancer treatment can affect your appetite, eating habits, and weight, but it is important for sufferers of cancer to maintain a healthy weight and lean muscle mass to keep the strength needed to fight the disease.
* An effective resistance training program during and after treatment can have positive outcomes, including a higher resistance to fatigue as well as improving physical performance and quality of life.

### Recommendations

Resistance exercises should target major functional muscles of the upper and lower limbs, and trunk. Ensure correct technique
* 6-9 different exercises with 60–90 seconds recovery between sets
* 1-4 sets per muscle, training at: 50-80% of 1RM or 6-10 RM
Program should be incremented as patients improve to maximize training response:
* Increase number of repetitions, from 6 to 12; then
* Increase number of sets, from 1 to 4, dropping the number of repetitions back to 6 each time a set is added; then
* Increase the load or resistance and reduce the number of repetitions and sets.
Resistance exercise combinations should be performed 2-3 times per week, on non consecutive days. Exercises should include:
* Chest press
* Lat pull-down
* Squat or leg press
* Leg extension
* Shoulder press or lateral arm raise
* Leg curl
* Seated row
* Triceps extension
* Biceps curl
* Core stability exerercises

## Further reading

Progressive Resistance Exercise Training For Patients After Treatment For Lung Cancer
Cancer Council. Guidelines for Implementing Exercise Programs For Cancer Patients

## References

* ↑ Lung cancer | Cancer Australia. 2014. Lung cancer | Cancer Australia. http://canceraustralia.gov.au/affected-cancer/cancer-types/lung-cancer.
* ↑ Cancer Australia. Report to the Nation - Lung Cancer 2011. Cancer Australia, Sydney, NSW, 2011
* ↑ Cancer Australia. Investigating symptoms of lung cancer: a guide for GPs Cancer Australia, Surry Hills, NSW, 2012.
* ↑ Australian Cancer Incidence and Mortality (ACIM) Books – All Cancers combined for Australia (ICD10 C00-C97, D45-46, D47.1, D47.3). www.aihw.gov.au/cancer/data/acim_books [Accessed March 2014]
* ↑ Australian Cancer Incidence and Mortality (ACIM) Books - Lung cancer for Australia (ICD10 C33-C34). http://www.aihw.gov.au/acim-books/ [Accessed March 2014].
* ↑ Better Health Channel Sited: http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Resistance_training_the_health_benefits
* ↑ Ryan, J.L., et al., Mechanisms of cancer-related fatigue. Oncologist, 2007. 12 Suppl 1: p. 22-34.
* ↑ Dr. Carolyn Peddle, Dr. Kerry Courneya, Dr. Dave Fenton, Dr. Gordon Bell, Dr. Linda McCargar (2012). Progressive Resistance Exercise Training for Patients after Treatment for Lung Cancer: The Re-Train Trial. A study of Progressive Resistance Exercise Training for Post-Treatment Lung Cancer Patients,http://www.behaviouralmedlab.ualberta.ca/en/ResearchStudies/CompletedStudies/ProgressiveResistanceExerciseT.aspx
* ↑ net, C. (03/2014). Nutrition Recommendations During and After Treatment. Retrieved September 28, from http://www.cancer.net/navigating-cancer-care/prevention-and-healthy-living/diet-and-nutrition/nutrition-recommendations-during-and-after-treatment - See more at: http://reffor.us/index.php#sthash.Zgv1WXLD.dpuf
* ↑ Doyle, C., et al., Nutrition and physical activity during and after cancer treatment: an American Cancer Society guide for informed choices. CA Cancer J Clin, 2006. 56(6): p. 323-53.
* ↑ Cancer Council Western Australia. 2009. Guidelines for implementing exercise programs for cancer patients. https://www.cancerwa.asn.au/resources/2009-11-26-exercise-guidelines-manual.pdf.
* ↑ Cancer Council Western Australia. 2009. Guidelines for implementing exercise programs for cancer patients. https://www.cancerwa.asn.au/resources/2009-11-26-exercise-guidelines-manual.pdf.