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 Those who participated in a 12-week home-based walking program had
better sleep quality at both three and six months after the program.
The results reinforce similar findings in breast and colorectal
cancer patients, researchers say.
“Walking is safe, feasible and effective for patients. Just walk!”
said senior author Chia-Chin Lin, a nursing professor at Taipei
Medical University. Lin and colleagues have published several
studies in recent years about links between physical activity, sleep
and quality of life in lung cancer patients.
Lung cancer patients often experience sleep problems during and
after treatment, Lin said, which can affect quality of life and
cancer prognosis.
“With advances in lung cancer treatment, survival improves
significantly,” she told Reuters Health by email. “Any interventions
that can improve symptoms and quality of life are valuable.”
In a randomized controlled trial, Lin and colleagues studied 111
lung cancer patients, ranging in age from late 30s to early 80s.
Almost two thirds had stage 1 cancer.
Patients were divided into two groups, with one group of 56 patients
advised to walk at a moderate intensity for 40 minutes three times a
week. These patients recorded their exercise after every session,
participated in weekly exercise counseling sessions and wore wrist
monitors that collected subjective and objective sleep data such as
total sleep time, sleep onset time and sleep quality.
The other 55 patients received usual medical care and an opportunity
for exercise counseling after the study concluded.
“Traditionally, physical activities have not been emphasized in lung
cancer patients due to concerns about fragility and limited
cardiopulmonary function,” Lin said. “However, we found that
home-based walking programs may be a safe and feasible way to
improve emotion and sleep quality.”
The study also looked at circadian rhythms, sometimes known as the
body clock or rest-activity rhythms. In this case, researchers
measured how consistently patients woke and went to sleep at the
same times each day.
They found that exercise was linked to improved sleep quality.
People whose circadian rhythms were most disrupted got the most
benefit.
These rhythms are believed to influence several aspects of health
such as heart rate, sleep, inflammation and metabolism. Altered
circadian function can increase risk for a number of chronic
diseases, Lin said.
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“Clinicians have discovered that cancer patients with a dismal
prognosis but who have an intact circadian rhythm live much longer
than expected,” said Jim Grutsch, epidemiology professor at the
University of Illinois School of Public Health in Chicago who also
conducts cancer research on behalf of the Cancer Treatment Centers
of America in Zion, Illinois.
This study is the first randomized controlled trial that examines
the long-term effects of walking programs on lung cancer patients by
measuring data six months later, not just 30 or 90 days later, the
study authors write in the British Journal of Cancer.
One limitation of the study, however, is that it uses a home-based
walking program, which can contain biased self-reported data from
patients, Grutsch said by email. In addition, the study didn’t
measure at what point patients exercised during their circadian
cycle, which can affect health outcomes, he noted.
“Most cancer patient research focuses on exercise and nutrition. We
often forget sleep,” said Ann Berger, professor of nurse oncology at
the University of Nebraska Medical Center in Omaha. In a book
scheduled for release in December, Berger writes about the positive
effects of exercise and sleep on cancer patients.
Since 2000, groups such as the Oncology Nursing Society have looked
for more ways to improve cancer patient outcomes through sleep,
exercise, meditation and behavioral therapy, Berger told Reuters
Health.
“This focus is a reflection of the survivorship movement with cancer
patients,” Berger said. “We need to help our millions of cancer
survivors to stay healthy and prevent cancer reoccurrence and heart
disease.”
In the U.S., lung cancer is the leading cancer killer of both men
and women, according to the American Lung Association. In 2016, an
estimated 225,000 new cases of lung cancer will be diagnosed.
SOURCE: http://bit.ly/2giCDDk British Journal of Cancer, online
November 3, 2016.
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