An Evolving Role for Cancer Rehabilitation in the Era of Low-Dose Lung Computed Tomography Screening

Lung cancer is the number one cause of cancer-related death worldwide, and is often detected in the later stages. Use of low-dose chest computed tomography in at-risk patients provides earlier detection and is being adopted as the standard screening tool, replacing less precise methods of radiography and sputum cytology. In the past, late detection of disease meant that rehabilitation interventions attempted to salvage function and to improve aerobic capacity to the point where patients could tolerate the sometimes-extensive oncologic treatment, including lobectomy or pneumonectomy. Earlier detection may shift this toward more often addressing specific neuromusculoskeletal impairments, such as postthoracotomy pain or peripheral neuropathy, as patients with early-stage disease may not be as debilitated by chronic disease or metastases as those with late-stage lung cancer. Patients with advanced disease, however, will still require rehabilitation interventions, and this fragile population creates unique challenges. Rehabilitation professionals should look for ways to expand care to lung cancer patients, as both the number of those treated and the 5-year survival rate are expected to increase.