A project led by NHS Lothian to help people cope better with lung cancer treatment has allowed patients to live longer and spend less time in hospital.

Findings suggest national adoption of a programme where people received ‘prehabilitation’ support at the earliest stage possible would lead to patients collectively spending 10,000 fewer days a year in hospital.

The Early Prehabilitation in Lung Cancer project (EPIC project) looked at ways to try to minimise the impact of the cancer and side effects of treatments by taking steps as early as possible to help patients improve their physical and mental health – sometimes before their diagnosis was confirmed.

These early interventions to ‘prehabilitate’ patients focused on symptom control, nutrition, and physical activity.

50 patients being investigated for locally advanced and metastatic (stage 3 and 4) lung cancer were offered an assessment by a consultant in palliative medicine, a registered dietitian, and a rehabilitation physiotherapist.

A paper published in the British Medical Journal reported that the approach allowed people to live longer when compared to a historic group of lung cancer patients who had not received the support.

The project, centred on St John’s Hospital, Livingston, also showed the time spent by patients in hospital in the six weeks from diagnosis reduced by 75% - equating to freeing up an additional 10,000 bed/days a year if the project were to be scaled up across Scotland.

The project leader, Consultant in Oncology at the Edinburgh Cancer Centre, Dr Iain Phillips, said taking steps to prepare people mentally and physically for treatment benefits patients and helps the NHS:

“Approximately half of patients have lung cancer that is incurable at diagnosis, meaning it has spread outside the lung. Many people who are diagnosed with lung cancer have a lot of symptoms, are older, frailer and have other medical conditions. All these factors make giving treatment for lung cancer more challenging.

“By routine screening and expert intervention for symptom control, nutrition, and an individualised exercise programme, we reduce the amount of time patients spend in hospital whilst they are being investigated for lung cancer by 75%. It also appeared to increase how long patients lived. As well as this being positive for patients, it has a potential significant cost saving for the NHS.

“We hope that with an increasing number of new drugs available to treat lung cancer, further future work will assess whether prehabilitation may improve treatment rates and overall survival for our patients.”

The Chief Executive of Roy Castle Lung Cancer Foundation, Paula Chadwick, added:

“Being told you have lung cancer is devastating, and this heart-breaking situation is often compounded by lengthy stays in hospital, when all a person wants is to be at home with their loved ones.

“The results from the EPIC project are really encouraging and could dramatically improve a patient’s experience. By reducing how long a person is in hospital, we can help ease any immediate additional stress as well as potentially lengthening their life.”

The EPIC project was a joint working project between NHS Lothian and the pharmaceutical company Merck, Sharp and Dohme (MSD).

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