Mother and daughter hugging in front of their house

City of Hope approved for $7 million for lung cancer study in older adults

The five-year, multisite study will look at how physical activity before and after surgery affects recovery in an older patient population

City of Hope has been approved for nearly $7 million from the Patient-Centered Outcomes Research Institute (PCORI) to study how physical activity affects older adults undergoing lung cancer surgery.

Dan Raz, M.D., M.A.S.

The funding was awarded to Dan Raz, M.D., M.A.S., co-director of City of Hope’s Lung Cancer and Thoracic Oncology Program and an associate professor in the Division of Thoracic Surgery, and Virginia Sun, Ph.D., M.S.N., R.N., associate professor in the departments of Population Sciences and Surgery. 

“We are very excited about this study. Although we have made a lot of progress to improve recovery from lung cancer surgery with minimally invasive techniques, lung surgery can still be difficult to recover from, particularly for some older adults,” Raz said. “This study tests a personalized walking and lower extremity strengthening program that is delivered by telephone before and after surgery. Family caregivers are also empowered to motivate and walk with their loved ones undergoing lung surgery as part of this intervention. We think this will help older adults recover more quickly and become more active even after the study is over.” 

The five-year, randomized trial undertaken at multiple hospitals through the SWOG Cancer Research Network will test which strategy is best for improving surgical recovery care for this older population. Patients will be randomly assigned to two groups. One group will receive personalized walking programs and lower extremity strengthening exercises based on preoperative assessments, goal setting and self-monitoring using wrist pedometers. Additionally, family caregivers will be coached to serve as “walking buddies.” A control group will receive a booklet about the importance of physical activity and a pedometer for self-monitoring. 

Prevalent Among Older Americans

Lung cancer is an enormous public health problem among older Americans. The average age of people undergoing lung cancer surgery is 70. 

Physical activity has been shown to help older adults with lung cancer recover faster from surgery, reduce surgical complications and help patients and caregivers have a better sense of well-being. There is a critical need to develop interventions specifically for older adults that improve quality of life and reduce complications from lung cancer surgery.

Virginia Sun, Ph.D., M.S.N., R.N.

Previous studies of physical activity before and after lung surgery have focused largely on “one size fits all” interventions administered by rehabilitation experts. The purpose of this study is to test a telephone-based, personalized, perioperative physical activity intervention to improve recovery for older adults with lung cancer, as well as improve their overall well-being and that of their family caregivers after surgery.

Raz and Sun’s study was selected through a PCORI funding program specifically focused on comparative clinical effectiveness research that aims to optimize the physical and mental functioning of community-dwelling older adults and their caregivers across the aging continuum. Many older adults live with chronic health conditions, and family and friends often serve as primary caregivers to aging individuals. Currently, the health care system is not well-equipped to address these complex care needs of the rapidly growing and diverse older adult population in the United States.

Healthy Aging

“This study was selected for PCORI funding for its potential to answer the need for real-world comparative clinical effectiveness research across the aging continuum that could inform evidence-based clinical practice for this important population,” PCORI Executive Director Nakela L. Cook, M.D., M.P.H., said. “We look forward to following the study’s progress and working with City of Hope to share the results.”  

The award has been approved pending completion of a business and programmatic review by PCORI staff and issuance of a formal award contract. PCORI is an independent, nonprofit organization whose mission is to fund research that will provide patients, their caregivers and clinicians with the evidence-based information needed to make better-informed health care decisions.  

The study, “Perioperative Physical Activity in Older Adults Undergoing Lung Cancer Surgery,” is part of PCORI’s Healthy Aging: Optimizing Physical and Mental Functioning Across the Continuum initiative.

City of Hope is home to one of the few specialized research programs designed to meet the unique needs of older adults with cancer, the Center for Cancer and Aging, part of the Department of Supportive Care Medicine. The mission of the center is to join investigators from all cancer disciplines to study biology, treatment and survivorship issues that older adults with cancer face. City of Hope founded the Cancer and Aging Research Group, a national consortium of geriatric oncology researchers. The institution was recently rated “high performing” in geriatrics in U.S. News & World Report’s annual “Best Hospitals” rankings.