Physical Activity Coaching for Lung Cancer

Recruiting in Palo Alto (17 mi)

+12 other locations

Overseen by Dan Raz

Age: 18+

Sex: Any

Travel: May Be Covered

Time Reimbursement: Varies

Trial Phase: Academic

Recruiting

Sponsor: City of Hope Medical Center

Disqualifiers: Lung surgery in less than 14 days

No Placebo Group

Trial Summary

What is the purpose of this trial?

This trial compares telephone-based exercise coaching to self-monitored exercise for older adults having lung cancer surgery. The goal is to see if coaching helps improve their physical function more than just giving them written instructions. The coaching involves personalized exercise plans and motivational support.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the study team or your doctor.

What data supports the effectiveness of this treatment for lung cancer patients?

Research shows that exercise programs before lung cancer surgery can improve lung function, reduce hospital stay, and lower the risk of complications after surgery. This suggests that physical activity coaching and similar interventions may help lung cancer patients recover better after surgery. ^{1 2 3 4 5}

Is physical activity coaching safe for lung cancer patients?

The studies reviewed focus on the feasibility and effectiveness of physical activity programs for lung cancer patients, but they do not report any specific safety concerns, suggesting that these programs are generally considered safe for participants. ^{1 2 5 6 7}

How is the Physical Activity Coaching treatment for lung cancer different from other treatments?

This treatment is unique because it focuses on increasing physical activity through self-monitoring and telephone-based coaching, which can be done at home without supervision, making it more accessible and convenient compared to traditional in-person exercise programs. ^{1 2 3 5 8}

Research Team

Dan Raz

Principal Investigator

City of Hope Medical Center

Eligibility Criteria

This trial is for older adults scheduled for lung cancer surgery and their caregivers. It aims to see if phone coaching or self-monitoring can help maintain physical function during this time. Participants should be able to perform basic exercises and have access to a telephone.

Inclusion Criteria

Agreement to wear pedometer during study duration

I am 65 years old or older.

I am 18 years old or older.

Exclusion Criteria

My lung surgery is scheduled within the next 2 weeks.

Prospective participants who, in the opinion of the investigator, may not be able to comply with all study procedures (including exercise program and compliance issues related to feasibility/logistics)

Trial Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Pre-Surgery Coaching

Patients attend telephone-based coaching sessions 7-14 days before surgery

1-2 weeks

1 session (virtual)

Post-Surgery Coaching

Patients attend telephone-based coaching sessions at days 7, 14, 21, and 51 post-discharge

8 weeks

4 sessions (virtual)

Follow-up

Participants are monitored for functional capacity and quality of life at 30, 60, and 180 days post-discharge

6 months

Treatment Details

Interventions

• Self Monitored Physical Activity (Behavioural Intervention)
• Telephone-based Physical Activity Coaching (Behavioural Intervention)

Trial Overview The study tests two methods: one where participants receive regular phone calls from a coach who guides them through physical activities, and another where they monitor their own exercise routine without guidance.

Participant Groups

Group I: Arm I (Telephone-based coaching session) Experimental Treatment 6 Interventions

Patients attend telephone-based coaching sessions over 20-50 minutes once 7-14 days before standard of care surgery, and then at days 7, 14, 21, and 51 post-discharge, for a total of 5 sessions. Patients also receive a personalized physical activity program and set fitness goals. FCGs also receive coaching and serve as a walking buddy for their patient. Patients and FCGs also wear an activity monitor throughout the trial.

Group II: Arm II (Written education) Active Control 5 Interventions

Patients receive written educational materials on physical activity and cancer survivorship. Patients and FCGs also wear an activity monitor throughout the trial.

Who Is Running the Clinical Trial?

City of Hope Medical Center

Lead Sponsor

Trials

614

Recruited

1,924,000+

Robert Stone

City of Hope Medical Center

Chief Executive Officer since 2014

Juris Doctorate from the University of Chicago, Bachelor's degree in Political Science from the University of Redlands

Sumanta (Monty) Pal

City of Hope Medical Center

Chief Medical Officer since 2023

MD

National Cancer Institute (NCI)

Collaborator

Trials

14,080

Recruited

41,180,000+

Dr. Douglas R. Lowy

National Cancer Institute (NCI)

Chief Executive Officer since 2023

MD from New York University School of Medicine

Dr. Monica Bertagnolli

National Cancer Institute (NCI)

Chief Medical Officer since 2022

MD from Harvard Medical School

Findings from Research

Only 23-28% of surgical lung cancer patients met the recommended physical activity guidelines of 150 minutes per week, indicating a significant gap in pre- and post-operative physical activity levels.

Physical activity levels decreased after surgery, with patients averaging fewer daily steps (3934-8863) in the first 1-3 months post-surgery compared to preoperative levels, suggesting a need for interventions to enhance recovery and improve health outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Physical activity in surgical lung cancer patients: a systematic review. Zhou, W., Webster, KE., Smith, EL., et al.[2022]

In a study of 34 patients who underwent lung resection, those who received accelerometer-based exercise instruction significantly increased their daily steps to an average of 8039 steps compared to 4887 steps in the control group two months post-surgery.

The intervention group also showed greater improvements in light intensity physical activity (LPA) and moderate-vigorous intensity physical activity (MVPA), indicating that accelerometer-based guidance effectively enhances physical activity levels after lung surgery.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The effectiveness of an accelerometer-based physical activity enhancement intervention for patients undergoing lung resection - A pilot randomized controlled trial. Sunahara, M., Matsuzawa, R., Nakagawa, F., et al.[2023]

Postoperative exercise interventions for surgical lung cancer patients have high to moderate-quality evidence showing they can significantly improve exercise capacity and muscle strength, which are crucial for recovery.

Preoperative exercise interventions may also enhance exercise capacity and pulmonary function, reduce the risk of postoperative complications, and shorten hospital stays, although the evidence quality is lower.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of perioperative exercise interventions on lung cancer patients: An overview of systematic reviews. Zhou, W., Woo, S., Larson, JL.[2021]

Preoperative exercise-based interventions significantly improve pulmonary function in lung cancer patients before lung resection surgery, with standardized mean differences indicating meaningful enhancements.

Patients who participated in these exercise programs experienced shorter hospital stays and a reduced risk of postoperative complications, highlighting the intervention's potential to improve recovery outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Functional and postoperative outcomes after preoperative exercise training in patients with lung cancer: a systematic review and meta-analysis. Sebio Garcia, R., Yáñez Brage, MI., Giménez Moolhuyzen, E., et al.[2022]

The physical activity self-management program for lung cancer patients was feasible, with a high consent rate of 89% and an average of 4 consultations per participant, primarily initiated post-surgery.

While the program did not significantly increase physical activity levels or reduce sedentary time after 8 weeks, it helped maintain activity levels compared to typical declines reported in other studies, suggesting potential benefits that warrant further investigation in a randomized controlled trial.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

CAPACITY: A physical activity self-management program for patients undergoing surgery for lung cancer, a phase I feasibility study. Granger, CL., Irving, L., Antippa, P., et al.[2019]

A study of 23 operable non-small cell lung cancer patients showed that physical activity levels decreased after surgery but improved significantly by six months post-operation, nearly returning to preoperative levels.

Increased moderate-to-vigorous physical activity in the first month after surgery was linked to better health outcomes at six months, including improved walking distance, quality of life, and reduced fatigue, highlighting the importance of early postoperative activity.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Physical behavior and associations with health outcomes in operable NSCLC patients: A prospective study. Timmerman, JGJ., Dekker-van Weering, MGHM., Wouters, MWJMM., et al.[2019]

This study will assess the effectiveness of a 12-week home-based exercise and self-management program for lung cancer patients post-surgery, comparing it to usual care in a randomized controlled trial with 112 participants.

The primary outcome is improvement in physical function, measured by the EORTC QLQ c30 questionnaire, with secondary outcomes including health-related quality of life and exercise capacity, evaluated over 12 months.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effect of a postoperative home-based exercise and self-management programme on physical function in people with lung cancer (CAPACITY): protocol for a randomised controlled trial. Granger, CL., Edbrooke, L., Antippa, P., et al.[2022]

References

1. Germany pubmed.ncbi.nlm.nih.gov

Physical activity in surgical lung cancer patients: a systematic review. [2022]

2. England pubmed.ncbi.nlm.nih.gov

The effectiveness of an accelerometer-based physical activity enhancement intervention for patients undergoing lung resection - A pilot randomized controlled trial. [2023]

3. England pubmed.ncbi.nlm.nih.gov

Effects of perioperative exercise interventions on lung cancer patients: An overview of systematic reviews. [2021]

4. England pubmed.ncbi.nlm.nih.gov

Functional and postoperative outcomes after preoperative exercise training in patients with lung cancer: a systematic review and meta-analysis. [2022]

5. Ireland pubmed.ncbi.nlm.nih.gov

CAPACITY: A physical activity self-management program for patients undergoing surgery for lung cancer, a phase I feasibility study. [2019]

6. England pubmed.ncbi.nlm.nih.gov

Feasibility and acceptability of a physical activity behavioural modification tele-coaching intervention in lung transplant recipients. [2022]

7. Ireland pubmed.ncbi.nlm.nih.gov

Physical behavior and associations with health outcomes in operable NSCLC patients: A prospective study. [2019]

8. England pubmed.ncbi.nlm.nih.gov

Effect of a postoperative home-based exercise and self-management programme on physical function in people with lung cancer (CAPACITY): protocol for a randomised controlled trial. [2022]