CanBenefit
Research type
Research Study
Full title
CANcer BEhavioural Nutrition and Exercise FeasibilIty Trial
IRAS ID
253217
Contact name
Flavia Swan
Contact email
Sponsor organisation
University of Hull
Duration of Study in the UK
0 years, 6 months, days
Research summary
Research Summary
People with cancer affecting the lungs tend to be older and frailer compared to people with other cancers. As a result, they may have poorer quality of life and are less able to tolerate treatments for their cancer, such as chemotherapy. Exercise and nutrition support helps people with cancer, but not many older people are included in these studies.
We want to develop and test an exercise and nutrition programme that can be tailored to each patient to help them have the best possible quality of life from diagnosis to later stages of disease. This study is the first stage of the research when we find which exercise and nutrition programmes are best for this patient group and find how best to deliver the programme by talking to patients, carers and health care staff.Summary of Results
: Cancer behavioural nutrition and exercise feasibility trial (CanBenefit); interview findings
Older people with lung cancer are often frail and have other health problems to manage too. This makes it difficult for them to take part in and complete cancer treatments. Physical activity and a healthy diet are recommended for people with other types of cancer before, during, and after cancer treatments. But most of the studies have not included a lot of older people so we are designing a study for older people with lung cancer. We want to find out if they will benefit from physical activity and a healthy diet during cancer treatments too.
The first step in designing a physical activity and healthy diet study is to talk to older people with lung cancer, family carers and health professionals about what they think will be useful. We also want to find out about what may stop or help older people with lung cancer from taking part in a physical activity and healthy diet programme before, during and after cancer treatment.
We interviewed 12 patients, 10 family carers and 9 health professionals including doctors, nurses, physiotherapists and dietitians from Hull area during 2019.
The results showed four key findings:
1. Current healthcare provision:
Patients and carers said that they were not given any guidance on diet and physical activity unless they asked staff and they would like staff to offer more advice. The healthcare staff also said that there was no formal service to provide physiotherapy or dietary support so it did not happen routinely at hospital appointments.
2. Preferred information provision:
The few patients and carers who were given healthy diet help said it was a “can't have” list of foods. They also said there was little or no help given for the “can haves”, such as recipes, menus or ideas of how to cook with the recommended foods. Patients and carers preferred physical and nutritional information on a “told what to do” basis and they felt they needed help with safety to do any physical activity. Staff agreed that a “can have” or a “can do” list was important to include in a physical activity and healthy diet programme 3. Peer support:
The patients and carers felt very strongly that there was a need for a support group, although at diagnosis some preferred little or no social contact. Most of the patients wanted to talk to someone in a similar position, and even those who did not want to take part in group physical activity felt it would be useful to meet up with other patients to chat about their experience. Staff also thought support groups were very important and said that group physical activity could help patients to keep doing their activity programme.
4. Barriers to the physical activity and healthy diet programme:
a) Psychological:
Patients felt that at diagnosis they would struggle to take part in a physical activity and healthy diet programme as it would be too much to take on. They also worried about side-effects from cancer treatments and if cancer treatments would work or not. Staff had similar views and thought that fear would stop some patients from taking part in a physical activity and healthy diet programme before treatment had started.
b) Physical:
Most of the patients said that cancer treatment side-effects and their other health problems could stop them from taking part in a physical activity and healthy diet programme. They felt that doing physical activity the first week after chemotherapy treatment would be very difficult due to fatigue. The risk of infection also meant patients preferred to avoid outside activity. Staff agreed that possible side-effects from cancer treatments could stop patients from doing physical activity. Patients also explained that keeping to a healthy diet was difficult if they had any symptoms such as pain, nausea, metallic taste, altered smells and loss of appetite during cancer treatments.
c) Healthcare services barriers:
Healthcare staff felt that the lack of resources and time could stop them from being able to deliver a physical activity and healthy diet programme to patients unless extra help were provided.
In summary, older adults with lung cancer would welcome clear information and advice to help with physical activity and a healthy diet. But patients felt it could be difficult to take part because of the effects of diagnosis and cancer treatment. A physical activity and healthy diet programme needs to fit with what the patient needs and should look at their physical, psychological and social welfare as well.
The findings of this interview study helped with the design of a further small pilot study. This is testing a physical activity and healthy diet programme to see if it is acceptable to patients, families and staff. It is also testing to see if it helps improve patient quality of life and if patients are more able to take part and cope better with cancer treatments. You can learn more about this study at https://eur03.safelinks.protection.outlook.com/?url=https%3A%2F%2Fu2790089.ct.sendgrid.net%2Fls%2Fclick%3Fupn%3DXv3JSvJ-2B3M71ppf7N9agbRehJ-2Fi4xyo44sEgJVCl5BcbW9wgc64X2JjNxW-2BqMpAMcWQuRr4zwJ-2F2SRPuiJ-2Bfew-3D-3D2P_s_E1aO2-2BZlVOSJJV-2FajQqskegTd6IRomHYTi-2Fbt8SH3YImkznQNG9PGVpzhgv61wFaIjTW05LBZ7fMrqaEtMpZbs8Why2nyAnUVk3mfJL0jRWEL9cNK7TYXle7FxXA37Tuj-2FPoJDySJ-2FJE-2BNnlFr-2FnmUzurCVhzp45IA1iv-2F9jfOS-2FmntKIYS-2FqfOzl0UVwkjyLjUxYKXmn0d6PjHw4p8-2FXw-3D-3D&data=05%7C01%7Capprovals%40hra.nhs.uk%7C2d47909297434383055708da9bbfbe5a%7C8e1f0acad87d4f20939e36243d574267%7C0%7C0%7C637993545099020866%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=avu8gDADnOP4%2F9HmuWXQts99dnky1%2Bkk3%2FpgvcX%2BpnE%3D&reserved=0This work was funded by Yorkshire Cancer Research (HEND405) and sponsored by the University of Hull.
REC name
West Midlands - Edgbaston Research Ethics Committee
REC reference
19/WM/0029
Date of REC Opinion
17 Jan 2019
REC opinion
Favourable Opinion