Pulmonary and Extrapulmonary Impairments in Patients With Lung Cancer Awaiting Surgery
Condition: Lung Cancer
MeSH terms: Lung Neoplasms
Study type: Observational

Summary: 
      To detect comparatively the extent to which physical impairments are observed in patients
      with lung cancer awaiting lung surgery, comparing exercise capacity, pulmonary functions,
      muscle strength, physical activity, dyspnea, fatigue and quality of life between the patients
      with lung cancer and healthy individuals was aimed in current study.
    

Detailed description: 
      According to global cancer statistics, the most commonly diagnosing and the highest mortality
      rates belong to lung cancer. As known, patients with lung cancer suffer from many
      pathophysiological changes due to characteristics of the lung cancer and its cytotoxic
      treatments including chemotherapy and radiotherapy. Especially, these changes commonly occur
      in respiratory mechanics and gas exchange all of which resulted in pulmonary function
      impairment. Moreover, excessive weight loss, anemia, protein catabolism, muscle wasting,
      skeletal muscle atrophy and inhibition of muscle regeneration are observed in these patients
      in course of time.

      The 6-minute walk test provides valuable and valid knowledge about exercise intolerance in
      diseases. As known, progressive decline in exercise capacity is commonly observed in patients
      with lung cancer. The loss of muscle mass also happens not only peripheral muscle but also
      respiratory muscles in patients with lung cancer. Based on the limited studies regarding
      patients with lung cancer, weakness in respiratory muscles before surgery has been
      demonstrated. Furthermore, these patients experience fatigue and dyspnea perceptions all of
      which increase disease burden and afflict quality of life.

      According to the results of a study compared the patients with lung cancer before surgery and
      healthy individuals, the patients are less physically active than healthy individuals.
      Moreover, at the diagnosis stage, the patients have worse quadriceps muscle strength,
      nutritional status, mood and quality of life compared to others. After six months, the
      patients experience decreases in physical activity, 6-minute walk test distance, and muscle
      strength and worsening symptoms following chemotherapy, radiotherapy and/or surgery. On the
      other hand, it could not be clearly demonstrated in the literature to the amount of
      impairments of pulmonary function and respiratory muscle strength compared to healthy
      individuals.

      To reveal aforementioned impairments in patients with lung cancer before surgery is of
      importance in terms of being helpful in both determining the protective rehabilitation
      program and also reducing the disease burden and other possible factors in lung cancer.
      Therefore, the aim of the current study was to investigate the differences in exercise
      capacity, pulmonary functions, respiratory and peripheral muscle strength, physical activity
      level, dyspnea, fatigue and quality of life between the patients with lung cancer before lung
      surgery and gender and age-matched healthy individuals.
    

Observational model: Case-Control
Time perspective: Retrospective
Sampling method: Non-Probability Sample
Study population: 
        Twenty six patients with lung cancer and 21 healthy individuals were included in this
        study. All patients were referred from Gazi University, Faculty of Medicine, Department of
        Thoracic Surgery to Gazi University, Faculty of Health Sciences, Department of
        Physiotherapy and Rehabilitation. The patients with lung cancer who were decided to undergo
        lung surgery by thoracic surgeons were referred to the physiotherapist. Healthy volunteers
        were also recruited. Then, the patients were matched with healthy individuals according to
        statistically similarity of both age and gender.
      
Keywords: lung cancer; walk test; pulmonary functions; muscle strength; physical activity; quality of life