Exercise as it relates to Disease/Exercise effects in lung cancer
Lung cancer is the most common cancer in the Western World and has very poor survival rate (only 10–15% of patients survive 5 years or longer). In Australia, it is the fifth most common cancer but is the most common cause of deaths due to cancer. It is estimated in year 2020, 13640 people would be diagnosed with lung cancer in Australia. Physical activity has shown significant improvements on the quality of life, physical function and physical capacity in patients with lung cancer.
What is lung Cancer?
Lung cancer is uncontrolled epithelial cell growth within the lung tissues and airways of lungs. It can originate from any part of the lungs, including the trachea, bronchi, bronchioles and alveoli. There are two main types of lung cancers 
- non-small cell carcinoma (about 80% of all lung cancers)
- small cell carcinoma (about 20% of all lung cancers)
Etiology of lung cancer
- Tobacco smoking is the main cause which accounts for 80 to 90% of all cases.
- Environmental factors such as exposure to radon, diesel air pollutants, asbestos, chromium and uranium 
- Family history of lung cancer and previous lung disease.
Symptoms and treatment of lung cancer
Majority of adults with lung cancer are symptomatic when they are diagnosed and exhibit following symptoms:
- Cough * Dyspnoea * Hoarseness* Chest pain* Wheezing* Haemoptysis* Nausea/Vomiting* Swelling of face and arm * Anorexia
- Weight Loss * Fatigue* Bone pain* Clubbing* Headache* Seizures.
Treatment of lung cancer depends upon the type and stage of the cancer, and includes# Radiotherapy # Surgery # Chemotherapy # Targeted therapy. Treatment methods have variety of associated side effects e.g. Cancer therapy has negative effects on cardiovascular system which leads to higher mortality in cancer patients.
Benefits of Exercise in Lung Cancer
- Improves physical fitness and quality of life
- Improves cardio respiratory fitness by increasing VO2 peak
- Enhances both maximum aerobic capacity and walking distance
- May also diminish side-effects of chemotherapy and radiation therapy
- Improves the psychological stress connected with cancer and its treatment, improves mood and reduce anxiety
- May decrease fatigue pre- and post-operatively
- An important component of cancer rehabilitation
|Exercise||Program||Duration (min/session)||Intensity (% of VO2peak)||Aims|
|Warm up||Exercises for upper and lower limbs like stationary cycling, treadmill||10 min||Low to moderate intensity||Enhances speed and strength in muscles|
|Aerobic training||• Circuit training
• Walking training • Cycling ergometry
3-5 sessions / week
|55% to 90%VO2peak||Improves cardio-respiratory fitness|
|Strength training||Leg press, chest press, lateral machine, leg extension, abdominal crunch, and lower back||20–60 min 3-5 sessions / week||60-80% of 8-10 sets rep. max||Improves skeletal muscle function and cardio-respiratory function|
|Stretching||For large muscles||25-45 min 3 sessions/ week||Duration of each stretch 5 min||Increase agility and flexibility|
|Yoga||Mind and body relaxation by improving respiration||15-20 min 2-3 times /week||-||Improves fatigue, distress, and general quality of life|
Note: Breathing exercises such as diaphragmatic breathing, pursed lip breathing are helpful in improving breathlessness. Positioning of patient is also an important component during breathing exercises.
Perceived barriers to exercise
- Age: average age of LC patients at the time of diagnosis is high (above 60years)
- Co-morbidities: COPD, arterial hypertension, cardiac disease, peripheral vascular disease, previous tumours and diabetes
- LC symptoms: fatigue, dyspnea, anorexia and pain
- Emotional well being: depression, anxiety, lowered self esteem and loss of sense of control
Strategies to improve exercise participation and adherence
- Exercise programs tailored according to patient’s condition
- Management of cancer symptoms and treatment complications
- Psychological and social counseling
- Educational and motivational sessions
- Physical activity integrated into cancer treatment plan
- Encouraging Oncologist to prescribe physical activity
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