Developing CanBenefit: CANcer BEhavioural Nutrition and Exercise FeasIbility Trial

Older adults with intra-thoracic malignancy are often frail and unfit due to their cancer and co-morbidities. This may affect ability to tolerate or receive cancer treatments. Irrespective of treatment eligibility or receiving best supportive care, this group experience poorer quality of life (QoL) than younger counterparts and other cancer groups. Evidence suggests that physical activity (PA) and healthy diet behaviour improve QoL among people with a cancer diagnosis before, during, and post-treatment. These behaviours may also positively impact treatment completion rates, leading to improved survival rates. However, older, frailer lung cancer populations tend to be excluded from this research under the assumption they are too high a risk to participate. As such, there is very little existing research to inform an intervention among this population.

To assess the acceptability, usefulness, and practicality of delivering a tailored wellbeing programme for older adults with lung cancer before, during, and after cancer treatment.

People with inoperable lung cancer ≥70 years of age, their informal carers, and Multidisciplinary Team (MDT) members were invited to participate in semi-structured interviews with the intention of determining acceptability, usefulness, and practicality of tailored wellbeing programme and specific feedback on individual components to be included. Participants were identified by a clinician in the clinic; informal carers were also invited to participate if they were interested. Topic guides were developed and used for all interviews.

Twenty interviews were conducted and transcribed. Patient interviews have been coded and analysed; final thematic coding is underway for clinician interviews. Preliminary assessment indicates participants welcome a holistic wellbeing programme designed to improve QoL. Initial feedback on delivery, content, and how to frame the intervention included ensuring it was individually tailored, incremental, and focused on maintaining daily activities. Patients were wary of anything that may add to their distress during diagnosis and treatment phases.

Preliminary results from this study have highlighted important considerations and components in developing a tailored wellbeing programme for people with lung cancer. Particularly, it may be beneficial to begin with mindfulness training immediately after diagnosis and then progress to more activity in later stages.