Impact of the Oncologist's Recommendation on Exercise Levels and Quality of Life in Patients With Lung Cancer: The ORE Randomized Controlled Trial.

BACKGROUND

Although physical activity is associated with improved survival in lung cancer, most patients remain inactive. This study examined the impact of an oncologist's recommendation on exercise quantity, sedentary behavior, and quality of life (QoL) in patients with lung cancer.

METHODS

In this single-blind, 3-arm randomized controlled trial, patients with lung cancer (stages I-IV) were assigned to: (1) usual care, (2) the oncologist's verbal and written exercise recommendation, or (3) the recommendation plus a printed exercise guidebook. Exercise, sedentary behaviors, and QoL were assessed at baseline, 4, and 8 weeks. Descriptive statistics, analysis of variance, and a generalized linear regression model were used to analyze data.

RESULTS

Overall, 91 patients (n = 31 recommendation group, n = 31 recommendation + guidebook group, n = 29 controls) were randomized. At 8 weeks, the recommendation group showed a significant increase in total (+270 min/week, p = 0.03) and light-intensity physical activity (+236 min/week, p = 0.01) versus controls. The recommendation plus guidebook group demonstrated a near-significant increase in total (+251 min/week, p = 0.05) and moderate-intensity physical activity (+145 min/week, p = 0.05). No significant changes were observed for sedentary behaviors. Regarding QoL, at 4 weeks, the recommendation plus guidebook group demonstrated an enhancement in cognitive function and the recommendation group in social function compared to controls. At 8 weeks, the recommendation + guidebook group reported improved constipation compared to the controls.

CONCLUSIONS

A brief oncologist-delivered recommendation effectively increased the total physical exercise in patients with lung cancer. Combining the oncologist's recommendation with a dedicated guidebook may be more effective in promoting moderate- and vigorous-intensity exercise, although the short follow-up limits conclusions regarding long-term effects.

TRIAL REGISTRATION

ClinicalTrial.gov identifier: NCT05497544.

© 2026 The Author(s). Cancer Medicine published by John Wiley & Sons Ltd.