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, one of the largest cancer research and treatment organizations in the United States, today announced that it 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.

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.

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.

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.

“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, and City of Hope was recently rated “high performing” in geriatrics in U.S. News & World Report’s annual “Best Hospitals” rankings.

About City of Hope

City of Hope's mission is to deliver the cures of tomorrow to the people who need them today. Founded in 1913, City of Hope has grown into one of the largest cancer research and treatment organizations in the U.S. and one of the leading research centers for diabetes and other life-threatening illnesses. As an independent, National Cancer Institute-designated comprehensive cancer center, City of Hope brings a uniquely integrated model to patients, spanning cancer care, research and development, academics and training, and innovation initiatives. Research and technology developed at City of Hope has been the basis for numerous breakthrough cancer medicines, as well as human synthetic insulin and monoclonal antibodies. A leader in bone marrow transplantation and immunotherapy, such as CAR T cell therapy, City of Hope’s personalized treatment protocols help advance cancer care throughout the world.

With a goal of expanding access to the latest discoveries and leading-edge care to more patients, families and communities, City of Hope’s growing national system includes its main Los Angeles campus, a network of clinical care locations across Southern California, a new cancer center in Orange County, California, scheduled to open in 2022, and Cancer Treatment Centers of America. City of Hope’s affiliated family of organizations includes Translational Genomics Research Institute and AccessHope^TM. For more information about City of Hope, follow us on Facebook, Twitter, YouTube, Instagram and LinkedIn.

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