Bloom Syndrome Complicated by Low-Grade Lymphoma and Non-small Cell Lung Cancer: A Case Report
For People With Lung Cancer, Exercise Can Be Gruelling. It's Also Among The Most Important Things
When you think of lung cancer treatment, what comes to mind – chemotherapy, radiation, surgery? While these can be crucial, there's another powerful tool that's often overlooked: exercise.
Our recent study, published in the Journal of Science and Medicine in Sport, challenges the common belief that people with lung cancer are too sick to be physically active.
In fact, we found exercise can play a vital role in improving life for those battling this disease.
What we did and what we foundOur review involved analysing 26 high quality studies on how best to incorporate exercise into treatment for lung cancer.
We found the overwhelming weight of evidence shows exercise offers benefits at every stage of the lung cancer journey. This includes:
When we say "exercise," we're not talking about running marathons. For someone with lung cancer, it might mean:
The key is to start slowly and listen to your body. What works for one person might not work for another.
Getting started safelyIf you or a loved one has lung cancer and wants to be more active, start by talking with your doctor. They can advise on any precautions you should take and send you to an exercise specialist if needed.
You might also consider working with an exercise physiologist or physiotherapist who can design a safe, personalised program.
It's OK to start small – even five to ten minutes of activity is beneficial, according to the Cancer Council Australia .
Try to be consistent, if you can. Regular, gentle exercise is better than occasional intense bursts.
It can help to keep track of your progress and how you feel after each session. You might also try looking for support groups or exercise classes specifically for cancer patients at local hospitals or community centres.
The Cancer Council Australia website offers inspiration and ideas on exercises to start with, even in the home.
The real-world benefitsResearch shows regular physical activity can significantly improve quality of life for lung cancer patients. These can include:
Lung cancer is the second most common cancer diagnosed worldwide. It's a devastating illness that affects not just the body, but also a person's mental health and quality of life.
Unfortunately, there's often a stigma attached to lung cancer. Many patients feel judged, or that they must have done something – such as smoking – to "deserve" their diagnosis.
This shame can prevent people from seeking help or joining support programs.
But here's an important truth: anyone can get lung cancer, even if they've never smoked.
And regardless of how someone developed the disease, they deserve compassion and the best possible care – including support for physical activity.
Never too late to startIt's important to note exercise can be beneficial even for those receiving palliative care.
In palliative care, the goals shift from fighting the cancer to enhancing comfort and quality of life, and physical activity can play a significant role in this.
Even palliative care patients may benefit from exercise. PeopleImages.Com - Yuri A/ShutterstockA lung cancer diagnosis is undoubtedly daunting. But we're learning patients have more tools to improve their wellbeing than we once thought.
Exercise isn't a cure, but it can be a powerful complement to traditional treatments and medications.
If you or someone you know is facing lung cancer, don't be afraid to discuss incorporating exercise into the treatment plan with your health-care team. Start small, be patient and consistent, and remember that every bit of movement counts.
By challenging old assumptions and embracing exercise as part of lung cancer care, we can empower patients to take a more active role in their treatment.
I Still Reflect On My Lung Cancer Treatment Decisions
When I was diagnosed with lung cancer, I didn't want to receive chemotherapy, especially when I was a good candidate for immunotherapy.
Sue McCarthy received diagnoses of breast cancer in 2001 and lung cancer in 2018. Catch up on all of Sue's blogs here!
For the past six years, I've wondered why my primary treatment for lung cancer was cisplatin, a harsh chemotherapy, despite the fact that my PD-L1 test results were at 60%, which made me an excellent candidate for immunotherapy.
Six years ago this month, I sat in the waiting room of my hospital's cancer center, anticipating my first appointment with my new doctor. The medical oncologist had come highly recommended by my thoracic surgeon.
I trusted my surgeon and felt comfortable with him. He had removed malignant tumors, one from each of my lungs in the summer of 2018. My non-small cell lung cancer was diagnosed as stage 3B: two tumors and eight cancerous lymph nodes, taken from my chest during the first of my two surgeries.
Despite feeling discouraged and rather negative, I sensed a bit of optimism for one reason and one reason only. My thoracic surgeon had my PD-L1 tested and the results, at 60%, indicated there was a good chance I would benefit from a checkpoint inhibitor type of immunotherapy. Not only was I happy with what my surgeon had shared with me, but I was also terrified of chemotherapy.
As I continued to wait for the doctor in an examination room, anxious thoughts bounced back and forth in my mind, from my fear of chemo to my hope in the newer cancer treatment: immunotherapy. It would use my own immune system to kill cancer cells. In my mind, there was very little doubt that immunotherapy was the better choice for me, specifically better than platinum-based chemotherapy. I was feeling good as the doctor walked in; I sensed that my oncologist would trust the PD-L1 results and choose immunotherapy as my primary treatment. However, not so! Why not? I wondered.
It was hard for me to even listen to the oncologist after he started talking about my planned chemotherapy regimen. Cisplatin and Alimta (pemetrexed disodium) were in the drug cocktail which I would receive every three weeks. My oncologist's manner indicated that he was stressed; I sensed no compassion in his voice.
I saw myself only as a victim that day. A life-threatening cancer had taken hold of me and then a reputable oncologist had just explained to me what I must do to survive. I knew I must tell him that I had a high PD-L1 score of 60% and I did, yet he gave me no explanation for his choosing cisplatin as my primary cancer treatment. And I wondered.
Yet, in a matter of minutes, my experience changed significantly. As a new oncology patient, I needed to have blood work done, and as I waited for the phlebotomist, my doctor tapped me gently on the shoulder and quietly said, "It will be OK." I felt relieved. He cared.
One week later, after another scan to make sure there was no change in the stage of my cancer, and a procedure to implant a port in my upper left chest, it was time to begin chemotherapy. I was called into the treatment area, this time with a much different attitude; I was absolutely ready to begin the infusion.
Resilience is a trait I've had many chances in life to practice — from years of family issues to earlier serious illnesses. I smiled at the kind, caring oncology nurse, but was not surprised as she read me the long list of side effects commonly suffered by patients with cancer who receive cisplatin. In anticipation of intense fatigue, nausea, diarrhea and vomiting, my husband drove us home. However, it took almost four days for me to become ill.
My chemotherapy treatment had taken place on Thursday, Sept. 6, 2018, but it wasn't until the following Monday evening that the full force of the harsh, platinum-based chemo, went to work on my body. I felt sick — sicker than I had felt in my entire life. Maybe chemo would do me in. I was scared I wouldn't make it. Not just physically, but mentally and emotionally. At that point, I was too sick to wonder.
Anxiety gripped me as I called the oncology office first thing Tuesday morning. I was able to get an appointment to see the doctor later that day, but the movement of the car and my sense of nausea as my husband drove toward the doctor's office caused me to vomit before we arrived at the cancer center. I clung to my husband, enabling me to walk the short distance from the parking lot to the medical building.
The medical assistant took my vital signs, and all were fine. However, I weighed only 103 pounds, despite my height of 5 feet 6 inches. One of my oncologist's associates examined me more thoroughly and diagnosed me with dehydration. "Drink more fluids," he said. "You are fine. All your symptoms are normal."
Astounded to hear that, I felt a bit embarrassed but trusted the doctor and appreciated that I was not nearly as ill as I thought I might be. I knew I would get through that first round of chemotherapy. Drinking water, even sip by sip, was a priority, as was eating simple and bland food that my stomach could tolerate.
From that point forward, I did well with all my treatments, including the optional immunotherapy I received at the end of my treatment. Some would question why I continue to wonder about the immunotherapy as my primary treatment, but to me, it was completely clear: if not to help me, then to help the next patient.
I visited my daughter for the weekend soon after and while at their home I talked to my son-in-law, a PhD research microbiologist. He explained to me: PD-1 is a protein found on T cells that helps control the body's immune response. When PD-1 is attached to another protein, PD-L1, it helps keep T cells from destroying cancer cells. The checkpoint inhibitor immunotherapy blocks PD-1 and allows T cells to kill cancer cells. Again, I understood some more, and again I wondered.
Today I saw my primary care physician for my annual exam, and when the topic of my lung cancer journey came up, he said, "That…PD-L1 score saved your life."
I thought, but for only a moment. Then again, I wondered. Why?
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5 Reasons Nonsmokers Get Diagnosed With Lung Cancer
Lung cancer is often associated with smokers or former smokers, and though doctors say about 80% of cases occur in smokers or former smokers, an alarming 20% of cases affect people who have never smoked.
"A variety of environmental factors, aside from smoking, can contribute to someone's lung cancer risk, but the type of lung cancer that nonsmokers develop often differs from the type of lung cancer that smokers develop," said Dr. Mohan Kulkarni, a thoracic surgeon at Henry Ford Health. "While lung cancer in smokers forms as a roundish spot, lung cancer in nonsmokers is diffused or less concentrated to one area. Lung cancer in nonsmokers is also usually slower growing."
It is important to note that outcomes for nonsmokers who are diagnosed with lung cancer tends to be more favorable than smokers. That's according to a recent study in which Henry Ford Health participated.
"Never-smokers may have better lung cancer outcomes partly because they are generally healthier," said Christine Neslund-Dudas, Ph.D., an associate research scientist at Henry Ford Health who contributed to the study. "They're able to fight cancer and tolerate treatment better than heavy smokers. "While we've known active smoking is related to poor outcomes of lung and other cancers, we wanted to look into this further because there's been a rising number of never-smokers who are developing lung cancer.
Kulkarni identified five different environmental risk factors for lung cancer beyond smoking, and offered advice on how to reduce exposure:
1. AsbestosAsbestos, a mineral fiber used in construction for its durability and heat resistance, can cause lung cancer. Although banned in many applications, it may still be present in older buildings.
"Before embarking upon construction projects -- especially if you live in an old home -- have a trained professional determine whether you have asbestos and where it is," Kulkarni said.
Safe removal by professionals is crucial to prevent airborne fibers from harming your lungs.
2. High-temperature cookingAsian females who never smoked are increasingly developing lung cancer, partly due to high-temperature cooking methods like stir-frying.
"Frequently cooking with oil at high heat creates carcinogens that are detrimental to the lungs."
To reduce this risk, it's important to have good kitchen ventilation and use other cooking methods like steaming or microwaving.
3. Outdoor air pollutionPollutants from vehicles, industrial sources and wildfires can harm lung health.
According to the American Cancer Society, there are likely hundreds of thousands of lung cancer deaths worldwide that can be attributed to particulate matter (PM) pollution -- particles smaller than 10 micrometers in diameter.
PM particles are small enough to penetrate deep into the lungs and bloodstream. To minimize exposure, check air quality on airnow.Gov before going outside and consider using an air purifier at home.
4. Radon gasAfter smoking, radon exposure is the second leading cause of lung cancer. The colorless, odorless and naturally occurring radioactive gas is found in soil.
Radon usually isn't a threat when it's outside because it disperses rapidly. However, radon can accumulate in basements through cracks in the foundation, which can become a health risk.
Testing for radon is essential, either through home inspections or DIY kits. If radon levels are high, professionals can install ventilation systems or increase air changes in the home.
5. Second and thirdhand smokeSecondhand smoke contributes to lung cancer risk, but thirdhand smoke is also harmful.
"Thirdhand smoke is just as bad for you as secondhand smoke," Kulkarni said. "When someone smokes, cancer-causing chemicals cling to surfaces like clothing, hair, rugs, carpets, furniture, vehicles, bedding, drapes and walls."
These chemicals build up over time and are difficult to remove. Washing walls and ceilings with detergent and hot water can help, while clothing and bedding may need several washing cycles. Carpets, furniture and any thirdhand smoke absorbed behind walls or in insulation may require replacement.
"Many people often don't experience symptoms of lung cancer -- like a worsening cough, coughing up blood, chest pain, wheezing and more -- until lung cancer has progressed to stage 3 or 4, where it has spread outside of the lungs," Dr. Kulkarni warns. "If you are worried about potential environmental exposures and your lung cancer risk, don't hesitate to talk to your doctor."
To reduce your exposure to lung cancer risks, you can do things like get an air purifier for your home or check the air quality before you commit to outdoor activities.
To learn more about lung cancer and Henry Ford Health, tap or click here.
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