Exercise and the Lung Cancer Tumor Microenvironment
University of Arizona
Summary
There is increased interest and knowledge about the lung cancer tumor microenvironment (TME). Investigators hypothesize that patients with better baseline physiologic health will have better post-operative outcomes and that strenuous exercise will alter the TME and genetic make-up of the tumor, improving the tumor immune response. Investigators aim to identify the peri-operative and clinical outcomes that differ based on pre-operative VO2max, HRV and resting heart rate following resection of early-stage lung cancer. The physiologic states that are individual and measurable with wearable devices include but are not limited to VO2max, heart rate variability (HRV), and average resting heart rate. Investgators hypothesize that a patient's pre-operative physiologic function with higher VO2max, HRV and lower resting heart rate will be associated with improved peri-operative and post-operative outcomes. Second, investigators will compare alterations in TME based on targeted pre-operative exercise (60-80% of their VO2 max for 75min/week x2 weeks) compared to normal activity adults following resection of early-stage lung cancer. Investigators hypothesize that strenuous exercise in the pre-operative period will impact the TME by increasing levels of cytokines.
Description
Background Lung cancer continues to be the most common cause of cancer related death in both men and women. Patients have variable responses to treatment, whether they receive neoadjuvant therapy or surgery alone. Many of these variations can be attributed to known patient risk factors including age, smoking status, and BMI. However, there are more complex pathophysiologic factors that affect how patients respond and recover from all insults, including cancer. Lung cancer resides in a complex milieu known as the lung tumor microenvironment (TME). The TME includes the cellular makeup of the t…
Eligibility
- Age range
- 18+ years
- Sex
- All
- Healthy volunteers
- Yes
Inclusion Criteria: * lung cancer * low risk for submaximal exercise testing in accordance with the risk stratification guidelines published by the American Heart Association and the American College of Sports Medicine (AHA/ACSM criteria). Exclusion Criteria: * younger than 18 years of age * select a condition on the ACSM-AHA pre-exercise screening questionnaire indicating that physician approval is required prior to exercise * body mass index of \>30 kg/m2 * waist girth of \>102cm for men and \>88cm for women * have chronic/debilitating arthritis * have been bedridden in the past three mon…
Interventions
- BehavioralEXERCISE TRAINING WITH OR WITHOUT MEDICATION
All patients will be offered a lab exercise regimen. For completion of Aim 2, only three or four visits are necessary, amounting to approximately 4 hours of the patient's time. The initial visit will be for pre-exercise screening. If the patient is deemed healthy enough to participate, an exercise test to determine the ventilatory threshold of the participant will be conducted and the VO2 determined. In the subsequent visits, the patient will perform exercise for 30 minutes at 15% above the volunteer's ventilatory threshold. Ideally, the patients will be able to complete a minimum of three sessions prior to surgery.
Location
- University of Arizona Cancer CenterTucson, Arizona