Neoplasms

Respiratory Tract (Lung and Bronchial) Diseases

All Conditions

Lung Neoplasms

Respiratory Tract Neoplasms

Thoracic Neoplasms

Lung Diseases

Respiratory Tract Diseases

Prescribed Activity designed to improve patient participation and adherence to prescriptions to increase physical activity and will include: (1) an educational session at enrollment, (2) subject communication via tailored electronic messaging, and (3) a wrist-bound device (FitBit Flex 2).

Usual care group will receive standard of care management from their Oncologist.

Educational session at enrollment, increase subject communication via tailored electronic messaging, and use of a wrist-bound device (FitBit Flex 2)

Prescribed Activity

Brett Bade, M.D.

The investigators will evaluate the feasibility of implementing a low-intensity, patient-centered activity regimen (PCAR) that prioritizes education and communication over a 12-week period in advanced stage lung cancer patients. The primary outcomes will include number of patients increasing their overall step count over the study period and adherence to step count recommendations. Secondary outcomes will include quality of life (QoL), dyspnea, and depression scores before and after the intervention as well as a patient feedback questionnaire (to guide further interventions). The goals are to increase overall step count and obtain adherence of \>50% of participants. The investigators will also assess whether the physical activity regimen influences markers of inflammation and glucose control and novel markers of cancer.

Feasibility of an Activity Regimen in Patients With Advanced Stage Lung Cancer

Assessing the Feasibility of a Patient-centered Activity Regimen in Patients With Advanced Stage Lung Cancer

Participants will wear a Fitbit wrist band that will record step count.

Exercise Adherence will be defined as (the number of weeks a subject follows the activity prescription)/(the number of "usable" weeks). A week is considered "usable" if 5/7 days of step counts are available, and days with \<200 steps/day are considered not usable.

Assessed via self-report using the Modified Medical Research Council. Dyspnea Scale, a single-item scale scored 0-4; higher score indicates worse dyspnea.

Assessed via self-report using the Patient Health Questionnaire, Depression Module (PHQ-9). a 9-item questionnaire that assesses depressive symptoms over the preceding two weeks. Each item is scored 0-3 (0 = "Not at all"; 1 = "Several days"; 2 = "More than half of days"; 3 = "Nearly every day"). A total score is calculated by taking the sum of questions 1-9, and a higher score indicates worse depression.

Assessed via self-report using the European Organization for the Research and Treatment of Cancer, Quality of Life Questionnaire (QLQ-C30, Version 3). The scale measures quality of life in 30 questions with 15 subscales:

Global health status/Quality of Life (QoL) scale, range 0-100, higher score = better quality of life.

Assessed via self-report using the European Organization for the Research and Treatment of Cancer, Quality of Life Questionnaire (QLQ-C30, Version 3). The scale measures quality of life in 30 questions with 15 subscales. One of the 5 functional scales measure physical functioning.

The range of score is 0-100; higher score = better functioning.

Assessed via self-report using the European Organization for the Research and Treatment of Cancer, Quality of Life Questionnaire (QLQ-C30, Version 3). The scale measures quality of life in 30 questions with 15 subscales. One of the 5 functional scales measures role functioning.

The range of score is 0-100; higher score = better functioning.

Assessed via self-report using the European Organization for the Research and Treatment of Cancer, Quality of Life Questionnaire (QLQ-C30, Version 3). The scale measures quality of life in 30 questions with 15 subscales. One of the 5 functional scales measures emotional functioning.

The range of score is 0-100; higher score = better functioning.

Assessed via self-report using the European Organization for the Research and Treatment of Cancer, Quality of Life Questionnaire (QLQ-C30, Version 3). The scale measures quality of life in 30 questions with 15 subscales. One of the symptom scale measures fatigue.

The range of score is 0-100; higher score = better functioning.

Assessed via self-report using the European Organization for the Research and Treatment of Cancer, Quality of Life Questionnaire (QLQ-C30, Version 3). The scale measures quality of life in 30 questions with 15 subscales. One of the 5 functional scales measures cognitive functioning.

The range of score is 0-100; higher score = better functioning.

Assessed via self-report using the European Organization for the Research and Treatment of Cancer, Quality of Life Questionnaire (QLQ-C30, Version 3). The scale measures quality of life in 30 questions with 15 subscales. One of the symptom scale measures nausea and vomiting The range of score is 0-100; higher score = better functioning.

Assessed via self-report using the European Organization for the Research and Treatment of Cancer, Quality of Life Questionnaire (QLQ-C30, Version 3). The scale measures quality of life in 30 questions with 15 subscales. One of the symptom scale measures pain.

The range of score is 0-100; higher score = better functioning.

Assessed via self-report using the European Organization for the Research and Treatment of Cancer, Quality of Life Questionnaire (QLQ-C30, Version 3). The scale measures quality of life in 30 questions with 15 subscales. One of the 5 functional scales measures social functioning.

The range of score is 0-100; higher score = better functioning.

Assessed via self-report using the European Organization for the Research and Treatment of Cancer, Quality of Life Questionnaire (QLQ-C30, Version 3). The scale measures quality of life in 30 questions with 15 subscales. One of the scales measure dyspnea.

The range of score is 0-100; higher score = higher symptoms burden.

Assessed via self-report using the European Organization for the Research and Treatment of Cancer, Quality of Life Questionnaire (QLQ-C30, Version 3). The scale measures quality of life in 30 questions with 15 subscales. One of the scales measure insomnia.

The range of score is 0-100; higher score = better functioning.

Assessed via self-report using the European Organization for the Research and Treatment of Cancer, Quality of Life Questionnaire (QLQ-C30, Version 3). The scale measures quality of life in 30 questions with 15 subscales. One of the scales measure appetite loss The range of score is 0-100; higher score = higher symptoms burden.

Assessed via self-report using the European Organization for the Research and Treatment of Cancer, Quality of Life Questionnaire (QLQ-C30, Version 3). The scale measures quality of life in 30 questions with 15 subscales. One of the scales measure constipation.

The range of score is 0-100; higher score = higher symptoms burden.

Assessed via self-report using the European Organization for the Research and Treatment of Cancer, Quality of Life Questionnaire (QLQ-C30, Version 3). The scale measures quality of life in 30 questions with 15 subscales. One of the scales measure diarrhea.

The range of score is 0-100; higher score = higher symptoms burden.

Assessed via self-report using the European Organization for the Research and Treatment of Cancer, Quality of Life Questionnaire (QLQ-C30, Version 3). The scale measures quality of life in 30 questions with 15 subscales. One of the scales measure financial difficulties.

The range of score is 0-100; higher score = higher symptoms burden.

The investigators will use the Physical Activity Questionnaire that measures this outcome in minutes.

The investigators will obtain serum CRP, a marker of inflammation.

The investigators will obtain serum leptin, a marker of glucose control. .

The investigators will obtain serum insulin level, a measure of glucose control.

The investigators will collect soluble PD- L1, a novel cancer marker.

The investigators will collect soluble PD- 1, a novel cancer marker.

Medical University of South Carolina

VA Connecticut Healthcare System

National Cancer Institute (NCI)

Yale University

Prescribed Activity designed to improve patient participation and adherence to prescriptions to increase physical activity and will include: (1) an educational session at enrollment, (2) subject communication via tailored electronic messaging, and (3) a wrist-bound device (FitBit Flex 2).

Prescribed Activity: Educational session at enrollment, increase subject communication via tailored electronic messaging, and use of a wrist-bound device (FitBit Flex 2)

Intervention Group

Control Group

Total

Age, Continuous

Sex: Female, Male

White

Other

Race/Ethnicity, Customized

Dr. Brett Bade

Baseline

6 weeks

12 weeks

This outcome was measured only in the intervention group.

Overall Step Count

This outcome was measured only in the intervention group. The 19 participants were each followed for 12 weeks. Thus 19 participants were followed for a total of 228 weeks.

Number of Weeks Participants Adhered to Step Count Recommendations

Dyspnea

Depression

Change in Quality of Life: Global Health Status

Change in Quality of Life: Physical Functioning

Change in Quality of Life: Role Functioning

Change in Quality of Life: Emotional Functioning

Change in Quality of Life: Fatigue

Change in Quality of Life: Cognitive Functioning

Change in Quality of Life: Nausea/Vomiting

Change in Quality of Life: Pain

Change in Quality of Life: Social Functioning

Change in Quality of Life: Dyspnea

Change in Quality of Life: Insomnia

Change in Quality of Life: Appetite Loss

Change in Quality of Life: Constipation

Change in Quality of Life: Diarrhea

Change in Quality of Life: Financial Difficulties

A 12 week outcome was not available for one subject in the control group.

Moderate Aerobic Exercise

Vigorous Aerobic Exercise

Only n=10 patients provided baseline and follow-up samples; 6 in the intervention group and 4 in the control group.

Spots Global Cancer Trial Database for prescribed activity