CARDIOPULMONARY REHABILITATION IN LUNG CANCER

Lung cancer is a type of cancer that is usually diagnosed late and has a low life expectancy due to its incidence, high mortality, initial asymptomatic course.

The incidence of lung cancer in 100,000 people in the United States is 60.1 per year in men and women, and deaths are 48.4 for both genders. According to International Cancer Agency’s newly diagnosed cancer estimates for 2012, the most diagnosed cancer in the world is lung cancer (13.0%), while deaths from cancer are also the most common in lung cancer (19.4%).It has been stated that if the rate of cancer growth continues in this way, there will may be a total of 19.3 million new cancer cases in 2025 due to the increase in the world’s population and the aging of the population.It has been shown that more than half of cancer cases and deaths from cancer occur in less developed countries.

The incidence of cancer in Turkey has similarities with the world and the developing countries of the world. In Turkey, it was found 269.7 per hundred thousand for men and 173.3 for women in 2009.Lung cancer is the most common cancer in first place for men (66%) while lung cancer is in the 5th place in women (8.1%).In recent years, it has also been increasing in women.Half of patients with lung cancer are diagnosed at an advanced stage.5-year life expectancy in lung cancer is 15%. If diagnosed early, this rate increases to 52.6%.However, only 15% of patients are able to get a diagnosis at an early stage. In cases with lung cancer, there may be an underlying chronic lung disease, or there may be other comorbidities independent of it.

In primary lung cancer cases, the prevalence of chronic obstructive pulmonary disease (COPD) was reported to be 73% in men and 53% in women.The incidence of postoperative complications such as atelectasis, pneumonia, acute respiratory failure requiring intubation or mechanical ventilation was found to be high in the patient population with a combination of COPD and lung cancer.In a prospective study conducted in 2014 investigating comorbidities and postoperative pulmonary complications, it was reported that 55% of the patients had cardiac comorbidities (past myocardial infarction, myocardial revascularization, stent placement, rhythm disorders, hypertension, myocardiopathy).

Other comorbidities; renal, diabetic, peripheral vascular diseases, mild and moderate COPD, obesity. In addition to the comorbidities mentioned above, it has been reported that patients with lung cancer who have a high smoking habit often have decreased exercise capacity, resting dyspnea, fatigue, restlessness, and polyneuropathy. In other studies, it was determined that in addition to these findings in patients with lung cancer, symptoms such as depression, anxiety, nausea, insomnia and weight loss were also observed.

USED SCALES
1-ECOG Performance scale
2-KARNOFSKY scale
3-CHARLSON scale
4-MMRC dyspnea scale

CARDIOPULMONARY REHABILITATION PROGRAM
1-Airway cleaning = Cleaning is done with a shaker assist device.
2-Resistance exercise training = Shoulder abdominis with free weights or resistance band. and flex. , subext. knee ext. is made.
3-Aerobic exercise = Continuous exercise on the treadmill.
4-Excretion of secretion = Percussion and positioning are performed.

SHORT-TERM GOALS
1-Teaching respiratory control.
2-Ensuring lung hygiene.
3-Reduce shortness of breath.
4- Improving lung ventilation.

LONG-TERM GOALS
1-Increasing peripheral muscle strength.
2- Increasing the exercise capacity.
3-Reducing fatigue.
4-Improving the quality of life.
5-Getting exercise habit.

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