The Neuroendocrine-Immune Mechanisms of Physical Activity on Behavioral Symptoms in Lung Cancer Patients---A Comparison of Patients Receiving Active Treatments and Survivors

Lung cancer has been the leading cause of cancer death in Taiwan; therefore, issues related to survival and quality of life are especially important for cancer patients. Treatments for lung cancer will cause symptom distress, especially behavioral symptoms, including sleep disturbance, fatigue, and depression. The neuroendocrine immune mechanisms underlying these symptoms remain unknown. The purposes of this study are to ⑴ follow up and compare the changes of flattened cortisol slope, melatonin rhythm, rest-activity rhythm, behavioral symptoms, quality of life in different treatments during the active treatment period, (2) examine the effect of physical activity during active treatment period on survival, (3) explore the relationship of physical activity to flattened cortisol slope, melatonin rhythm, rest-activity rhythm, behavioral symptoms, and quality of life, (4) investigate during the active treatment period, the effect of exercise training on flattened cortisol slope, melatonin rhythm, rest-activity rhythm, behavioral symptoms, quality of life, and survival, (5) investigate during survivorship, the effect of exercise training on flattened cortisol slope, melatonin rhythm, rest-activity rhythm, behavioral symptoms, quality of life, and survival, In the first and second years of this study, a prospective longitudinal study design will be used and in the third and forth years of study, the experimental design will be undertaken. Instruments include ELISA. motion sensors, actigraphy, EORTC-QOL-C30, LC13, Hospital Anxiety and Depression Scale, Pittsburgh Sleep Quality of Life Index-Taiwan form, and Brief Fatigue Inventory-Taiwan form. Statistical analyses include descriptive statistics, t-test, one-way ANOVA, latent growth modeling, and GEE. Results from this study will provide important implications for improving symptom management and quality of life for elderly lung cancer survivors.