Andrew Murnane

Low physical activity levels and functional decline in individuals with lung cancer

OBJECTIVES Physical activity has been infrequently measured objectively in non-small cell lung cancer (NSCLC). We aimed to investigate levels of physical activity, functional and patient reported outcomes at diagnosis and over six months in participants with recently diagnosed NSCLC and compare results with both physical activity guidelines and outcomes of similar-aged healthy individuals. METHODS This prospective observational study assessed 50 individuals from three Australian tertiary hospitals with stage I-IIIB NSCLC at diagnosis, then 10 weeks and six months later. Thirty five healthy individuals without cancer were assessed once. Outcome measures included tri-axial accelerometery (number of steps per day), six minute walk distance (6MWD), muscle strength and questionnaires including health-related quality of life (HRQoL). RESULTS Individuals with NSCLC were engaged in significantly less physical activity than similar-aged healthy individuals, with 60% not meeting physical activity guidelines. At diagnosis they had worse quadriceps strength, nutritional status and HRQoL. Over six months, participants with NSCLC experienced decline in self-reported physical activity, 6MWD and muscle strength, and worsening symptoms. CONCLUSION At diagnosis individuals with NSCLC engage in less physical activity, are weaker and more depressed than healthy individuals and their self-reported physical activity declines over six months. Future studies are required to investigate the efficacy of interventions to increase physical activity.

The exercise programming preferences and activity levels of cancer patients undergoing radiotherapy treatment

IntroductionResearch has shown that patients who undergo regular physical activity during cancer treatment have significantly better physical functioning, cardiorespiratory fitness, psychological well-being and quality of life than those who do not. Despite the apparent value of exercise, few patients undertake regular physical activity during treatment and usually find it difficult to return to pre-treatment levels of activity following treatment completion. The purpose of this study was to compare pre-treatment versus on-treatment activity levels of outpatients receiving radiotherapy at a cancer centre in Australia and to identify patients’ preferences and barriers to exercise during this time.MethodsOne hundred and twenty consecutive patients undergoing radical radiotherapy were approached. Ninety-two patients (77%) answered questions on medical and demographic variables, past and current activity levels and exercise counselling and programming preferences.ResultsPatients reported a decrease in the time spent exercising once radiotherapy treatment started and were less likely to engage in strenuous activities. Seventy-nine percent of patients reported that cancer and its treatments had affected their ability to exercise. Seventy-one percent wanted information about exercise during treatment and preferred to receive this information from an exercise specialist who is affiliated with the hospital. A home-based independent exercise program was preferred by 53% of patients but there was less consistency around when to begin an exercise program.ConclusionsThe study indicates that a significant proportion of cancer patients undergoing radiotherapy want information, counselling and support regarding exercise and exercise programming.

The impact of an inpatient hospital admission on patient’s physical functioning and quality of life rate in the oncology setting

Paul A James, Lara Petelin, Ian Campbell, Hugh Dawkins, Stephen Fox, Janet Hiller, Judy Kirk, Geoffrey Lindeman, Finlay Macrae, Lyon Mascarenhas, Julie McGaughran, Bettina Meiser, April Morrow, Cassandra Nichols, Nicholas Pachter, Christobel Saunders, Clare Scott, Nicola Poplawski, Letitia Thrupp, Alison Trainer, Robyn Ward, Mary-Anne Young, Gillian Mitchell