Getting cancer patients' lungs back in working order is the domain of Vickie Shannon, M.D., professor in the Department of Pulmonary Medicine and director of Pulmonary Rehabilitation (PR) at MD Anderson.
“Although the majority of our patients are referred to PR for chronic obstructive pulmonary disease (COPD), we have successfully treated many patients with other chronic respiratory conditions.
“That includes those resulting from primary and metastatic cancers of the lung, thoracic resection and chronic lung injury secondary to cancer therapies, such as stem cell transplantation, radiation and chemotherapy,” Shannon says.
Until several decades ago, physicians thought that patients with severe chronic respiratory conditions such as COPD were incapable of exercise. “That’s been debunked. Patients with all phases of COPD can work out,” Shannon says.
“The impact that shortness of breath, fatigue and reduced ability to exercise have on quality of life is grossly overlooked in patient care. Patients feel empowered when they can engage in activities that they couldn’t do before, such as climbing a flight of stairs or taking a shower.”
Through the pulmonary clinic, patients undergo a six-minute walk exam, exercise physiology testing and quality-of-life assessments. These are used to evaluate the safety of exercise and factors contributing to exercise limitation, then to develop an individualized exercise prescription.
Afterwards, patients are referred to physical and occupational therapists in the Rehabilitation Center at MD Anderson. The goal is to optimize their pulmonary status so they can more easily enter treatment or continue treatment and regain some quality of life.
Research in rehab
The mainstay of ‘cure’ for early-stage lung cancer is surgery, Shannon says. But certain patients aren’t eligible because of borderline lung function.
She is investigating whether several weeks of preoperative PR improves surgical eligibility and lung cancer resection outcomes among this group of patients.
“Our investigation will explore the minimum optimum duration of preoperative PR that favorably impacts surgical outcomes in patients anticipating thoracic resection for lung cancer,” she says.