Treatment further worsens physical function in NSCLC

Patients with non-small cell lung cancer (NSCLC) already have poorer physical health and quality of life (HRQoL) compared with healthy individuals. Treatment for this type of cancer makes these issues even worse, with patients becoming less physically active, according to a study.

In the study, 76 patients (mean age 66 years, 65 percent male) with a diagnosis of NSCLC who underwent assessments at diagnosis and 12–15 weeks after treatment initiation. These assessments included peripheral and respiratory muscle strength, functional exercise capacity (6-min walk distance [6MWD], 1-min sit-to-stand [1MSTS]), objectively measured physical activity (PA), and patient-reported outcomes on symptoms and HRQoL. The same assessments were conducted for 46 healthy individuals (mean age 64 years, 59 percent male).

At diagnosis, NSCLC patients performed significantly worse than healthy individuals across most outcomes. Furthermore, at 12 weeks postsurgery, patients showed significant worsening of 1MSTS (−2 reps; p=0.03), 6MWD (−24 m; p=0.008) performance, self-efficacy for PA, dyspnoea, physical wellbeing, and lung cancer-specific symptoms (p<0.05).

The worsening was more pronounced among patients who received (neo-)adjuvant therapy. Specifically, systemic chemotherapy led to significant worsening of self-efficacy to perform PA (p=0.03), while radiotherapy resulted in further reduction in self-reported PA (p<0.05) and increase in fatigue (p=0.04) but improved mental wellbeing (p=0.03). Patients across all treatment subgroups showed significantly lower PA post-treatment compared with healthy individuals.

These findings highlight the importance of implementing rehabilitation programs in NSCLC care.