DECLINE IN PHYSICAL FUNCTION (PF) IS ASSOCIATED WITH PRETREATMENT DEPRESSIVE SYMPTOMS, DECREASED MOBILITY, MORE PAIN, AND DYSPNEA IN OLDER CANCER PATIENTS REFERRED FOR SYSTEMIC CANCER TREATMENT

19673 Background: In order to properly support clinical decisions, geriatric assessment (GA) is recommended for older cancer patients. However, the best form of GA remained unknown and recent studies demonstrated that usual GA tools may have a ceiling effect in detecting adverse outcomes to cancer treatment. Frailty has emerged as a concept characterizing cumulative declines across multiple physiologic systems, leading to increased vulnerability and risk of adverse outcomes. Consequently, the concept of frailty may represent a more sensitive way to better characterize health and functional status and to detect potential vulnerability to adverse outcomes in older cancer patients. The purpose of this pilot study was to explore the usefulness of frailty markers in older cancer patients. Methods: This cross- sectional study included 50 cancer patients, (70 years and older) referred to an oncology clinic for chemotherapy. Chronic diseases, IADL and ADL disabilities, and seven domains considered as frailty markers (nutrition, mobility, strength, energy, physical activities, mood and cognition) were assessed. Patients were classified into hierarchical groups based on the results of their assessment. Results: While 15 (30%) patients had at least one disability in IADL and 8 (16%) patients had at least one disability in ADL, 27 patients (54 %) were completely independent for IADL and ADL. Among those patients with no IADL nor ADL disability, 21 patients (42%) presented at least one frailty marker. In the whole cohort, 44 patients (88%) had at least one frailty markers. The most prevalent of the frailty markers were nutrition, mobility and physical activity (respectively 62%, 58% and 42%). Conclusion: Markers of frailty add substantial information to the usual GA tools in detecting potential vulnerability in older cancer patients. Additional studies are needed to determine if the addition of the frailty markers to the usual GA tools can help to better characterize the older cancer population and predict risk of toxicities and adverse outcomes due to cancer treatment. No significant financial relationships to disclose.

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Feasibility and acceptability of yoga to improve psychosocial and physical function among patients with lung cancer: A pilot study.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.15_suppl.e24068 ◽

2020 ◽

Vol 38 (15_suppl) ◽

pp. e24068-e24068

Author(s):

Mary E Medysky ◽

Donald Richard Sullivan ◽

Anna Tyzik ◽

Charles R. Thomas ◽

Kerri M. Winters-Stone

Keyword(s):

Quality Of Life ◽

Lung Cancer ◽

Depressive Symptoms ◽

Cancer Treatment ◽

Physical Function ◽

Grip Strength ◽

Chair Stand ◽

Hand Grip ◽

After Cancer

e24068 Background: Patients with lung cancer suffer from depression symptoms, reduced quality of life (QOL), and declines in physical function during and after cancer treatment. Since yoga is a low energy demand form of exercise, we hypothesized that yoga is a feasible, safe, and efficacious strategy to mitigate these problems in lung cancer patients. Purpose: 1) Determine the feasibility, acceptability, and safety of a yoga program in patients (pts) with lung cancer during or soon after cancer treatment; 2) Determine the preliminary efficacy of yoga to improve depressive symptoms, quality of life, and physical function among pts with lung cancer. Methods: This study was a single group 12-week (wk) pilot trial of low-moderate intensity yoga among pts with stages I-IV lung cancer (n = 20) during (n = 14) or after (n = 6) cancer treatment. Assessments conducted at baseline, 6- and 12-wks included the Patient Health Questionnaire-8, Functional Assessment of Chronic Illness Therapy-Lung (FACT-L), 6-minute walk distance (6MWD), hand grip strength, chair stand time, and flexibility (back scratch and sit-reach) tests. Results: At baseline, 20 pts, including those with metastatic disease (n = 8), enrolled and 7 pts (35%) withdrew by 6-wks due to poor/worsening health. No further withdrawals occurred at 12-wks. Among pts (n = 13) who completed the study, adherence to the intervention was 75% and 78% at 6 and 12-wks, respectively. No moderate or serious adverse events were reported. Over 12 wks, depressive symptoms (average = -1.8 ±1.23, 43.9% change) decreased, improvements in QOL improved (average = +4 ±2.9, 6.5% change),6MWD (average = +22.6m ±15.9, 6.5% change), hand grip strength (average = +1.6kg ±1.2, 5.7% change), chair stand time (average = -3sec ±2.1, 5.8% change), and upper (average = -10.8cm ±7.5, 49.4% change) and lower (average = -11.9cm ±8.4, 74.6% change) body flexibility occurred. Conclusions: In this sample of lung cancer pts, a 12-week yoga program was modestly feasible, was shown to be safe and potentially beneficial for psychosocial and physical function. Though retention was lower than expected due to early pt withdrawal for poor health, adherence to supervised practice among those pts who were able to complete the intervention exceeded the target goal. Among pts with stage I-IV lung cancer yoga may be a useful strategy to improve psychosocial outcomes and physical functioning, though alternate delivery approaches for pts with advanced disease deserves further exploration. Clinical trial information: NCT03649737 .

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