Physical Activity of Surgical Lung Cancer Patients
Creators: name: Zhou, Weijiao
Publisher: name: My University
Year: 2022
Subjects: subject: Lung cancer
subject: Physical activity
subject: Accelerometer
subject: Nursing
subject: FOS: Health sciences
subject: Health Sciences

description: Lung cancer is the second most diagnosed cancer and the leading cause of cancer-related death worldwide. Physical activity (PA) improves health outcomes after lung cancer treatment and PA guidelines recommend that cancer patients engage in 150 minutes of moderate PA per week. However, lung cancer patients may face multiple challenges to maintain PA, including aging, concomitant lung disease, skeletal muscle atrophy, depression, stigma, etc. Understanding the pattern and predictors of PA is a critical step in developing and implementing effective PA promotion interventions that could promote long term maintenance of PA. This three-paper dissertation focuses on PA promotion in this understudied population, and it includes a systematic review, a secondary analysis, and a pilot study. Perioperative exercise could improve health outcomes of surgical lung cancer patients, but little is known about their natural PA behaviors before and after surgery. We conducted a systematic review aimed to synthesize evidence describing the PA of surgical lung cancer patients. We included 17 studies and found that 1) 14 studies had sample sizes less than 100, 2) only 23-28% of lung cancer survivors met PA guidelines, 3) PA declined after surgery and it did not recover within 3 months following surgery, 4) perioperative PA was positively associated with exercise capacity, quality of life and reduced postoperative complications. Few studies have examined the actual volume and correlates of pre-diagnosis PA, especially using objective measures. In addition, little is known about how PA behaviors are similar/different between cancer types. We conducted a secondary analysis and compared pre-diagnosis PA and its correlates in patients with lung cancer and other types of cancer (breast, colorectal and prostate). This study used longitudinal data from the UK Biobank, which is a national cohort study with accelerometer data. We found that 1) lung cancer patients were the most physically inactive population before diagnosis, 2) younger age and faster walking pace were strong correlates of PA in all four types of cancer, while smoking status was a unique correlate in lung cancer, 3) higher pre-diagnosis moderate to vigorous PA (&gt;1.5h) was associated with a lower all-cause mortality risk. Large longitudinal studies with objective measures are needed to better understand the PA pattern and PA recovery of lung cancer patients. However, little is known about the feasibility and acceptability of using activity monitors among lung cancer patients, especially during the intensive perioperative period. This pilot study explored the feasibility and acceptability of tracking longitudinal PA using activity monitors (before surgery, at 1 week and 6-8 weeks after surgery and obtained preliminary estimates of PA changes). We recruited 21 participants and found that: 1) it was feasible and acceptable to track PA during this intensive perioperative period, 2) PA declined after surgery and it did not recover to preoperative level within 6-8 weeks after surgery. In conclusion, the results of this dissertation contribute to our knowledge of PA in lung cancer patients. Findings highlight the potential benefits of PA before diagnosis and during perioperative period. It also suggests that lung cancer patients are physically inactive before diagnosis, before and after surgery. The identified unique PA correlates (e.g., smoking status) suggests that cancer-specific approaches are needed in PA research and practice. In addition, activity monitoring is a feasible strategy to use in larger longitudinal studies before and after lung cancer surgery.