Abstract
Purpose: Few programs exist to address persistent impairment in functional status, quality of life, and mental health in lung cancer survivors. We aimed to determine whether a 12-wk multimodal survivorship program imparts clinical benefit.
Methods: Any patient at the Durham Veterans Affairs Medical Center with lung cancer and a Karnofsky score of >=60 could participate. Chronic obstructive pulmonary disease medications were optimized at the enrollment visit. Participants with a Hospital Anxiety and Depression Scale (HADS) score of >8 were offered pharmacotherapy and mental health referral. Participants did home-based exercise with a goal of 1 hr/d, 5 d/wk. They were called weekly to assess exercise progress and review depression/anxiety symptoms. Participants were offered pharmacotherapy for smoking cessation.
Results: Twenty-three (50%) of the first 46 enrollees completed the full 12-wk program. Paired changes from enrollment to completion (mean +/- SD) were observed in 6-min walk test (73.6 +/- 96.9 m, P = .002), BODE (Body mass index, airflow Obstruction, Dyspnea, and Exercise) index (-1.45 +/- 1.64 points, P < .001), Duke Activity Status Index (3.84 +/- 7.12 points, P = .02), Fried Frailty Index (-0.588 +/- 0.939 points, P = .02), modified Medical Research Council dyspnea scale (-0.619 +/- 1.284 points, P = .04), Functional Assessment of Cancer Therapy-Lung Emotional subscale score (1.52 +/- 2.96 points, P = .03), HADS total score (-2.63 +/- 4.34 points, P = .02), and HADS Anxiety subscale score (-1.47 +/- 2.29 points, P = .01).
Conclusions: A comprehensive Lung Cancer Survivorship Program provides clinically meaningful improvements in functional status, quality of life, and mental health.