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Improve Lung Cancer Surgery with PreOperative Exercise

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Surgical Removal of Early-Stage Lung Cancer can be Curative- Reduce Your Risk of Complications with Pre-Habilitation-

Starting in about 2015, I began to read studies about a concept called Pre-habilitation. Over the years, more and more studies have been published about the benefits of getting in shape for cancer patient’s treatments. The articles linked below focus on pre-habilitation for lung cancer patients about to undergo surgery.

It’s not rocket science and it may be low-tech therapy but it is evidence-based and it works. Give yourself every chance to cure your early stage lung cancer (LC) by pre-habilitating before your surgery.

The study linked and excerpted below documents three important facts about LC:

  • Surgery can be curative for early stage lung cancer
  • Surgery often leads to complications and
  • Preoperative exercise reduces the risk of the post-operative complications


Imagine that you have been diagnosed with LC. At first you are devistated. Then imagine that you are fortunate enough to have diagnosed your LC early enough to be a candidate for surgical removal of the tumor. Your surgery goes well. When you wake up your surgeon gently explains to you that the procedure went well and he/she “got it all.”

You fantasize that you are on your way to curing your lung cancer. In the weeks that follow your surgery you develop complications from your surgery-perhaps pneumonia, bronchopleural fistula or severe atelectasis.

You realize that you could have reduced your risk of the above complications if only you have undergone pre-habilitation.

I am a long-term survivor of an incurable cancer and cancer coach. Have you been diagnosed with early stage lung cancer? If you would like to learn more about your therapy choices, scroll down the page, post a question or comment and I will reply to you ASAP.

thank you,

David Emerson

  • Cancer Survivor
  • Cancer Coach
  • Director PeopleBeatingCancer

Recommended Reading:

Preoperative exercise training for patients with non-small cell lung cancer

“Background– Surgical resection for early stage non-small cell lung cancer (NSCLC) offers the best chance of cure, but is associated with a risk of postoperative pulmonary complications (i.e. pneumonia (new infiltrate coupled with either fever (> 38º C) and purulent secretions, or fever and white cell count > 11,000), bronchopleural fistula, severe atelectasis that requires chest physiotherapy or bronchoscopy, and prolonged mechanical ventilation (> 48 hours))…

Authors’ conclusions-Preoperative exercise training may reduce the risk of developing a postoperative pulmonary complication, the duration of intercostal catheter use, postoperative length of hospital stay, and improve both exercise capacity and FVC in people undergoing lung resection for NSCLC…”

P212 Prehab4Cancer: an innovative regional lung cancer prehabilitation service

Introduction and Objectives Surgical resection for lung cancer is physically and emotionally demanding for patients, with risks of complications and morbidity. Prehabilitation aims to maximise patients’ fitness, nutrition and wellbeing before treatment to improve outcomes. The existing literature on lung cancer prehabilitation points to improved functional capacity, post-operative length of stay & frequency of complications. As such, it is recommended in current guidelines.1…

Results Since April 2019, 380 lung cancer patients have been referred from 11 hospitals, with 75% participating. Average age was 70y; 53% were female. Median duration of prehab was 39 days, with mean 2.2 sessions/week. Physiological assessments such as incremental shuttle walk test (ISWT) improved from median 350 m at baseline to 380 m. Health-related quality of life measures also demonstrated improvement (see table 1)…

Conclusions Prehab4cancer has successfully implemented a regional cancer prehab programme that demonstrates feasibility and excellent uptake and improved patient experience. Collaboration has been key, between GM-wide healthcare professionals working together with the GM Cancer alliance, people affected by cancer and GM Active. Validated measures of fitness and quality of life show promising trends toward improvement among surgical lung cancer patients.”

Prehabilitation prior to lung cancer surgery: a small step forward

“Ever since the National Emphysema Treatment Trial (1), it has been clear that preoperative pulmonary rehabilitation improves function in patients preparing to undergo lung resection. However, the ensuing supporting comparative literature has consisted of small randomized trials and moderately sized cohort studies with a variety of limitations (2). We are left with mixed impressions as to the role of prehabilitation in patients awaiting lung cancer surgery.

In response, Liu and colleagues (3) conducted a randomized controlled trial of unselected patients undergoing thoracoscopic lobectomy at a university hospital in Beijing for non-small cell lung cancer (NSCLC). Patients were randomized to usual medical care or to a home-administered trimodality prehabilitation program (aerobic/resistance/pulmonary exercises, nutrition, and psychological support) for two weeks prior to surgery.

The primary endpoint was improvement in the six-minute walk distance (6MWD). Secondary outcomes were pulmonary function tests, quality of recovery, and physical and mental well-being…

So, what have they demonstrated? Primarily that a short but rigorous multimodal prehabilitation program can result in a measurable improvement in cardiopulmonary performance in generally young and fit patients. It is questionable whether this result will be replicated in a more heterogeneous population of patients with lung cancer, especially those seen in Europe and North America…

Thus, while their results do not provide further guidance regarding whether prehabilitation should be standard therapy for patients undergoing lobectomy for NSCLC, they do show us that methodologically sound studies on prehabilitation are possible.

Second, that not all patients with lung cancer are comparable in terms of baseline function and comorbidity. A large-scale multinational RCT would be necessary to address the scope of this question and to ascertain which patients truly stand to benefit from pre-habilitation…”



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