- Email: [email protected]
82 Investigating physical activity levels of lung cancer patients pre-intervention and feasibility of exercise class attendance post-intervention
S28
Posters, 9th Annual BTOG Conference, 2011: Other
108 patients treated at Guy’s and St Thomas’ Hospital over the last twelve years were identified through the cardiothoracic database. All has been referred to our quaternary referral service for biopsy with or without resection of a suspected thymic epithelial neoplasm with subsequent pathological confirmation. Data was collected regarding age, presentation, the need for biopsy, paraneoplastic phenomenon, PET scan correlation, surgical approach, stage, WHO subtype, neo/adjuvant chemo/radiotherapy and relapse/mortality data. While many patients present incidentally (23%), chest pain (17%), cough (14%) and myasthenia gravis (12.5%) were the commonest symptoms at diagnosis. 49 patients underwent biopsy before attempted resection. Documented Masoaka staging was reported in only 55 patients (I = 21, II = 12, III = 8, IV = 13) and a total of 51 with documented WHO pathological subtypes (Fig. 1).
difference is shown on Table 1 with 42.5% (13/31) of lung resection survivors reporting feeling unable to complete exercise classes (*p = 0.02). There was a trend towards CRRS (18.5%) citing physiological symptoms such as pain, weakness and fatigue as reasons discouraging possible class attendance (#p = 0.07) whereas surgical survivors cited both physiological and psychological reasons. Conclusion: Contrary to our hypothesis, no significant difference was found in pre-intervention activity levels between either group. Nearly half of resection survivors perceived an inability to attend exercise classes within 3 months of their surgery compared to a smaller proportion of CRRS. Post-resection care pathways need evaluation to promote effective symptom control and increased activity. Investigation of feasibility for resection survivors to utilise and evaluate the effectiveness of already established exercise groups is in pilot phase.
40
Table 1: Showing questions asked, categories of answers, raw numbers and percentages
30
Unclassified Carcinoma
20
Type AB Type B3
10
Type B2 0 d cla
ss
ifie
eC
Type A
Un
Ty p
B
eB Ty p
eA Ty p
Ty p
eA
Type B1
Figure 1. Thymic Epithelial Neoplasms by Subtype. A total of 18 patients received either or both chemo/radiotherapy in the neoadjuvant or adjuvant setting of which all histological subtypes and resection margins (R0-R2) were equally represented. 9 patients have died from their disease, 7 within 2 years of diagnosis and all with stage III/IV disease at presentation. Robust pathological and surgical staging is required along with pooled long term data to further establish the role of neo/adjuvant chemo/radiotherapy in order to establish which patients would benefit from such an approach. 82 Investigating physical activity levels of lung cancer patients pre-intervention and feasibility of exercise class attendance post-intervention E.M. Schofield, C.A. Ward, S.L. Elkin. Imperial College Healthcare Trust, London, United Kingdom Research suggests exercise can improve treatment side-effects such as weakness, fatigue and pain in survivors completing various interventions. Recovery rates and exercise levels in lung resection, chemotherapy and/or radical radiotherapy survivors (CRRS) needs further clarification from patient perspectives. Aim: To investigate physical activity levels before treatment and the feasibility of post-treatment exercise groups; hypothesising; 1. Resection survivors have greater activity levels than CRRS preintervention 2. Resection survivors have an increased likelihood to attend exercise classes after intervention. A questionnaire was developed, sent to lung cancer survivors diagnosed between May09 to May10. Information was collected on demographics, activity levels, exercise frequency pre- and postintervention and perceived ability to participate in a post treatment exercise class. Non-responders were contacted by telephone and/or the questionnaire was resent. Data was analysed using chi-squares. Results: Of 64 questionnaires 61% were returned (39/64), 21 lung resection and 18 CRRS responded; denominators less than 39 indicate missing data. Majority (59%) of respondents were male (23/39) and 45% (17/38) between age range of 61 70 years. The only significant
Activity levels prior to treatment Inactive (able to short distances <1 mile) Active (no limits on everyday activities) Exercise frequency prior to treatment No formal exercise Participation in exercise Perceived ability to participate in exercise class up to 3 months post treatment No Yes Reasons for declining to attend hypothetical exercise class Physiological Psychological
Surgical (%)
CRR (%)
Total
9 (24) 10 (27)
13 (35) 5 (13)
37
12 (34) 7 (19)
13 (36) 4 (11)
36
13 (42.5)* 3 (10)
6 (18.5) 9 (29) 31
9 (43) 5 (24)
7 (33) 0 (0)#
21
*p = 0.02, # p = 0.07.
83 Early results of a newly developed patient reported experience measure for the National Improving Lung Cancer Outcomes Project J. Draffan1 , S. Christie2 , L. Martin3 , S. Lally3 , I. Woolhouse3 . 1 National Lung Cancer Forum for Nurses, UK, 2 Roy Castle Lung Cancer Foundation, UK, 3 Royal College of Physicians, UK Background: National cancer patient satisfaction surveys are now commonplace, however responses from lung cancer patients are typically low. The Improving Lung Cancer Outcomes Project (ILCOP) is collecting patient experience data across England to guide quality improvement projects. We describe results from the initial benchmarking stage of the project. Method: The 30 Trusts participating in the project were asked to send questionnaires to 30 patients. The questionnaire consists of 12 multiple choice and 2 free text questions. They are returned anonymously to the ILCOP where the results are collated and fed back to the relevant trust. Results: 417 questionnaires have been returned. Patient experience was rated highly (>90% totally satisfied) for the sensitivity in which the diagnosis was given, clarity of answers to questions, privacy, respect and dignity. Areas that scored less well (<80% totally satisfied) were the explanations of tests and diagnosis, emotional support and physical support. The most powerful messages were seen in the free text section. For example, I was treated as an individual not just a number with personal attention which gave me confidence in the people treating me and I was in hospital and was told by 2 doctors who I had not seen before, there was no compassion shown. It was a case of you have lung cancer and someone else will come and explain everything. Conclusion: We have shown that it is possible to collect patient experience from a large number of lung cancer patients using a short
Posters, 9th Annual BTOG Conference, 2011: Other
108 patients treated at Guy’s and St Thomas’ Hospital over the last twelve years were identified through the cardiothoracic database. All has been referred to our quaternary referral service for biopsy with or without resection of a suspected thymic epithelial neoplasm with subsequent pathological confirmation. Data was collected regarding age, presentation, the need for biopsy, paraneoplastic phenomenon, PET scan correlation, surgical approach, stage, WHO subtype, neo/adjuvant chemo/radiotherapy and relapse/mortality data. While many patients present incidentally (23%), chest pain (17%), cough (14%) and myasthenia gravis (12.5%) were the commonest symptoms at diagnosis. 49 patients underwent biopsy before attempted resection. Documented Masoaka staging was reported in only 55 patients (I = 21, II = 12, III = 8, IV = 13) and a total of 51 with documented WHO pathological subtypes (Fig. 1).
difference is shown on Table 1 with 42.5% (13/31) of lung resection survivors reporting feeling unable to complete exercise classes (*p = 0.02). There was a trend towards CRRS (18.5%) citing physiological symptoms such as pain, weakness and fatigue as reasons discouraging possible class attendance (#p = 0.07) whereas surgical survivors cited both physiological and psychological reasons. Conclusion: Contrary to our hypothesis, no significant difference was found in pre-intervention activity levels between either group. Nearly half of resection survivors perceived an inability to attend exercise classes within 3 months of their surgery compared to a smaller proportion of CRRS. Post-resection care pathways need evaluation to promote effective symptom control and increased activity. Investigation of feasibility for resection survivors to utilise and evaluate the effectiveness of already established exercise groups is in pilot phase.
40
Table 1: Showing questions asked, categories of answers, raw numbers and percentages
30
Unclassified Carcinoma
20
Type AB Type B3
10
Type B2 0 d cla
ss
ifie
eC
Type A
Un
Ty p
B
eB Ty p
eA Ty p
Ty p
eA
Type B1
Figure 1. Thymic Epithelial Neoplasms by Subtype. A total of 18 patients received either or both chemo/radiotherapy in the neoadjuvant or adjuvant setting of which all histological subtypes and resection margins (R0-R2) were equally represented. 9 patients have died from their disease, 7 within 2 years of diagnosis and all with stage III/IV disease at presentation. Robust pathological and surgical staging is required along with pooled long term data to further establish the role of neo/adjuvant chemo/radiotherapy in order to establish which patients would benefit from such an approach. 82 Investigating physical activity levels of lung cancer patients pre-intervention and feasibility of exercise class attendance post-intervention E.M. Schofield, C.A. Ward, S.L. Elkin. Imperial College Healthcare Trust, London, United Kingdom Research suggests exercise can improve treatment side-effects such as weakness, fatigue and pain in survivors completing various interventions. Recovery rates and exercise levels in lung resection, chemotherapy and/or radical radiotherapy survivors (CRRS) needs further clarification from patient perspectives. Aim: To investigate physical activity levels before treatment and the feasibility of post-treatment exercise groups; hypothesising; 1. Resection survivors have greater activity levels than CRRS preintervention 2. Resection survivors have an increased likelihood to attend exercise classes after intervention. A questionnaire was developed, sent to lung cancer survivors diagnosed between May09 to May10. Information was collected on demographics, activity levels, exercise frequency pre- and postintervention and perceived ability to participate in a post treatment exercise class. Non-responders were contacted by telephone and/or the questionnaire was resent. Data was analysed using chi-squares. Results: Of 64 questionnaires 61% were returned (39/64), 21 lung resection and 18 CRRS responded; denominators less than 39 indicate missing data. Majority (59%) of respondents were male (23/39) and 45% (17/38) between age range of 61 70 years. The only significant
Activity levels prior to treatment Inactive (able to short distances <1 mile) Active (no limits on everyday activities) Exercise frequency prior to treatment No formal exercise Participation in exercise Perceived ability to participate in exercise class up to 3 months post treatment No Yes Reasons for declining to attend hypothetical exercise class Physiological Psychological
Surgical (%)
CRR (%)
Total
9 (24) 10 (27)
13 (35) 5 (13)
37
12 (34) 7 (19)
13 (36) 4 (11)
36
13 (42.5)* 3 (10)
6 (18.5) 9 (29) 31
9 (43) 5 (24)
7 (33) 0 (0)#
21
*p = 0.02, # p = 0.07.
83 Early results of a newly developed patient reported experience measure for the National Improving Lung Cancer Outcomes Project J. Draffan1 , S. Christie2 , L. Martin3 , S. Lally3 , I. Woolhouse3 . 1 National Lung Cancer Forum for Nurses, UK, 2 Roy Castle Lung Cancer Foundation, UK, 3 Royal College of Physicians, UK Background: National cancer patient satisfaction surveys are now commonplace, however responses from lung cancer patients are typically low. The Improving Lung Cancer Outcomes Project (ILCOP) is collecting patient experience data across England to guide quality improvement projects. We describe results from the initial benchmarking stage of the project. Method: The 30 Trusts participating in the project were asked to send questionnaires to 30 patients. The questionnaire consists of 12 multiple choice and 2 free text questions. They are returned anonymously to the ILCOP where the results are collated and fed back to the relevant trust. Results: 417 questionnaires have been returned. Patient experience was rated highly (>90% totally satisfied) for the sensitivity in which the diagnosis was given, clarity of answers to questions, privacy, respect and dignity. Areas that scored less well (<80% totally satisfied) were the explanations of tests and diagnosis, emotional support and physical support. The most powerful messages were seen in the free text section. For example, I was treated as an individual not just a number with personal attention which gave me confidence in the people treating me and I was in hospital and was told by 2 doctors who I had not seen before, there was no compassion shown. It was a case of you have lung cancer and someone else will come and explain everything. Conclusion: We have shown that it is possible to collect patient experience from a large number of lung cancer patients using a short