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Cited by 207Cancer survivorship and careLung Cancer Diagnosis and TreatmentPhysical Activity and Health

The DOI matches its Crossref record; 113 of the 114 references it cites were found in a registry or an index.

Physical Activity and Exercise in Lung Cancer Care: Will Promises Be Fulfilled?

Open access
Avancini, Alice, Sartori, Giulia, Gkountakos, Anastasios, Casali, Miriam, Trestini, Ilaria, Tregnago, Daniela, Bria, Emilio, Jones, Lee W., Milella, Michele, Lanza, Massimo, Pilotto, Sara·2020·The Oncologist
DOI 10.1634/theoncologist.2019-0463PMC PMC7066706
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Abstract

Lung cancer remains the leading cause of cancer-related death worldwide. Affected patients frequently experience debilitating disease-related symptoms, including dyspnea, cough, fatigue, anxiety, depression, insomnia, and pain, despite the progresses achieved in term of treatment efficacy. Physical activity and exercise are nonpharmacological interventions that have been shown to improve fatigue, quality of life, cardiorespiratory fitness, pulmonary function, muscle mass and strength, and psychological status in patients with lung cancer. Moreover, physical fitness levels, especially cardiorespiratory endurance and muscular strength, are demonstrated to be independent predictors of survival. Nevertheless, patients with lung cancer frequently present insufficient levels of physical activity and exercise, and these may contribute to quality of life impairment, reduction in functional capacity with skeletal muscle atrophy or weakness, and worsening of symptoms, particularly dyspnea. The molecular bases underlying the potential impact of exercise on the fitness and treatment outcome of patients with lung cancer are still elusive. Counteracting specific cancer cells' acquired capabilities (hallmarks of cancer), together with preventing treatment-induced adverse events, represent main candidate mechanisms. To date, the potential impact of physical activity and exercise in lung cancer remains to be fully appreciated, and no specific exercise guidelines for patients with lung cancer are available. In this article, we perform an in-depth review of the evidence supporting physical activity and exercise in lung cancer and suggest that integrating this kind of intervention within the framework of a global, multidimensional approach, taking into account also nutritional and psychological aspects, might be the most effective strategy. IMPLICATIONS FOR PRACTICE: Although growing evidence supports the safety and efficacy of exercise in lung cancer, both after surgery and during and after medical treatments, most patients are insufficiently active or sedentary. Engaging in exercise programs is particularly arduous for patients with lung cancer, mainly because of a series of physical and psychosocial disease-related barriers (including the smoking stigma). A continuous collaboration among oncologists and cancer exercise specialists is urgently needed in order to develop tailored programs based on patients' needs, preferences, and physical and psychological status. In this regard, benefit of exercise appears to be potentially enhanced when administered as a multidimensional, comprehensive approach to patients' well-being.

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Figure 1 Summary of the effects of exercise on body physiology, psychology, and biology in lung cancer.Abbreviations: FEV1, forced expiratory volume in one second; IGF‐1, insulin‐like growth factor 1; iNOS, inducible nitric oxide synthase; NK, natural killer; PI3KA, phosphoinositide 3‐kinase; QoL, quality of life; VEGF, vascular endothelial growth factor; WBC, white blood cells.
Figure 1 Summary of the effects of exercise on body physiology, psychology, and biology in lung cancer.Abbreviations: FEV1, forced expiratory volume in one second; IGF‐1, insulin‐like growth factor 1; iNOS, inducible nitric oxide synthase; NK, natural killer; PI3KA, phosphoinositide 3‐kinase; QoL, quality of life; VEGF, vascular endothelial growth factor; WBC, white blood cells.CC BY-NC-ND · PubMed Central
Figure 2 Tailored exercise program: a proposed model.
Figure 2 Tailored exercise program: a proposed model.CC BY-NC-ND · PubMed Central

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  1. Alves, 2018, das Neves W, Tobias GC et al. High intensity interval training slows down tumor progression in mice bearing Lewis lung carcinoma, J Cachexia Sarcopenia Muscle, 1, 60

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Authors
Avancini, A., Sartori, G., Gkountakos, A., Casali, M., Trestini, I., Tregnago, D., Bria, E., Jones, L. W., Milella, M., Lanza, M., & Pilotto, S.
Affiliations
  • University of Verona (IT)
  • Department of Diagnostics and Public Health, University and Hospital Trust of Verona, Verona, Italy
  • Università Cattolica del Sacro Cuore (IT)
  • Memorial Sloan Kettering Cancer Center (US)
  • Section of Medical Oncology, Department of Medicine, University of Verona, Italy
Corresponding author
Pilotto, Sara
ORCID
Venue
The Oncologist
Publisher
Oxford University Press (OUP)
Published
2019-11-26
Volume
25
Issue
3
Pages
e555-e569
ISSN
  • 1083-7159 (ISSN-L)
  • 1549-490X
DOI
10.1634/theoncologist.2019-0463
PMC
PMC7066706
OpenAlex
W2989969892
Cited by
207
References
114
Citations by year
2026: 33 · 2025: 37 · 2024: 41 · 2023: 31 · 2022: 33 · 2021: 20 · 2020: 10
FWCI
1.49
Type
journal article
Language
en
Open access
Licence
Locations
  • The Oncologist (publishedVersion, cc-by-nc-nd)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • PubliCatt (Università Cattolica del Sacro Cuore) (submittedVersion, other-oa)
Funders
  • International Association for the Study of Lung Cancer
  • Memorial Sloan-Kettering Cancer Center (CA008748, P30 CA008748)
  • Associazione Italiana per la Ricerca sul Cancro (20583, AIRC IG 20583, IG 20583)
  • National Cancer Institute (CA008748, P30CA008748)
Topics
  • Health Sciences › Medicine › Oncology › Cancer survivorship and care
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Lung Cancer Diagnosis and Treatment
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Physical Activity and Health
Keywords
lung cancer, physical activity, cancer-related fatigue, dyspnea, quality of life, cardiorespiratory fitness, muscle strength, skeletal muscle atrophy, smoking stigma, exercise recommendations
MeSH terms
Exercise Therapy, Humans, Lung Neoplasms, Physical Fitness, Quality of Life, Exercise, Muscle Strength

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