From Comments from David M. Waterhouse, MD, MPH, a medical oncologist, hematologist and Co-Director of Research at OHC who specializes in lung cancer. Article by European Society for Medical Oncology

January 24, 2019

Most people with lung cancer are unaware of the benefits of regular exercise, yet new data show it can significantly reduce fatigue and improve well-being. Results of two studies, presented at the European Society for Medical Oncology 2018 Congress in Munich last October, underline the value of exercise, including in patients with advanced or metastatic lung cancer.

Over half (54%) of patients with advanced cancer who completed an exercise survey were unaware of the benefits of exercise and only 22% achieved healthy activity levels, as recommended by the World Health Organization.

“For patients with advanced lung cancer, breathing is most likely compromised. And the treatments make you tired, so the last thing you might want to do is exercise,” explained David M. Waterhouse, MD, MPH, a medical oncologist, hematologist and Co-Director of Research at OHC who specializes in lung cancer. “The key is intensity and duration. We wouldn’t expect a patient with advanced lung cancer to run a marathon, but we would suggest they try to walk around the block. And they could lift some light hand-held weights while seated or try low intensity yoga. We’ve always known exercise is good for everyone for general good health, and now we know it’s beneficial for lung cancer patients.”

Nearly nine out of 10 patients in the survey had advanced lung cancer, and at least six out of 10 respondents said they did not exercise because of fatigue or shortness of breath. Over half named low mood, lack of motivation, pain and side effects of treatment as barriers to exercising.

“Exercise benefits everyone, not just those who are well, and gentle aerobic exercise and strength training should be as much a part of treating advanced lung cancer as anti-tumor therapy,” said Dr. Quan Tran, Medical Oncologist at the Cancer Care Centre, St Stephen’s Hospital, Urraween, Australia. “We need to break down the barriers that are stopping patients from exercising, for example by treating the anemia that may be causing their fatigue,” added Tran.

The Australian research also showed that patients who were less active had significantly less social support than those who were more active. Asked what type of activity program would be most helpful, respondents voted for education, group exercise classes, and other support at the same place they were receiving their cancer treatment.

“Patients preferred to get information and support and become more active in a buddy or group program than through web-based initiatives. They weren’t interested in competitions and incentives, but they did feel that being with others in a similar situation would motivate them to overcome their barriers to exercise,” Tran explained.

In a second study of 227 patients with advanced or metastatic lung cancer, those who did regular easy aerobic and muscle strengthening exercises improved their symptom scores by approximately 10% during chemotherapy.

“This is the first time that patients undergoing palliative care for lung cancer have been shown to benefit from exercise. Patients who exercised also felt more independent and needed less help with daily activities, and our research suggested that they may be able to have more and longer chemotherapy which, in turn, may result in better tumor control,” explained Dr. Joachim Wiskemann, Exercise Physiologist and Sports Psychologist, National Center for Tumor Diseases (NCT) and Heidelberg University Hospital, Heidelberg, Germany.

Wiskemann estimated that 50-60% of patients with advanced lung cancer are willing and able to exercise and recommends adapting the nature and setting for exercise to individual needs. He also stressed the importance of coordinated care with good commitment from oncologists and cancer nurses.

“As their cancer care team, we play a significant role in helping our patients exercise,” Dr. Waterhouse added. “It isn’t enough to simple say, ‘You should exercise.’ We help them identify what they can do considering their current status and treatment. If they’re at home, we need to understand available indoor space or the distance from the front door to the mailbox. If they want to go to a class, we help them determine the type of class and level of intensity that’s best for them. We are their partners through this entire journey, and that means more than just administering chemo. It’s taking time to fully understand their situation and providing them with everything they need to fight cancer.”

OHC (Oncology Hematology Care) has been fighting cancer on the front lines for more than three decades. We are the region’s leading experts in the treatment of nearly every form of adult cancer and complex blood disorder. OHC offers the latest medical, gynecologic and radiation therapy, and is always seeking better treatment options through participation in clinical trials. OHC is certified by the American Society for Clinical Oncology in the Quality Oncology Practice Initiative Certification Program, is an accredited Oncology Medical Home, and is one of only 179 practices nationally to be accepted into the Medicare Oncology Initiative. At its heart, our approach to cancer care is simple – to surround you with everything you need so you can focus on what matters most: beating cancer. For more information about services and careers at OHC, call 1-888-649-4800 or visit

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