# Progressive Activity-Based Rehabilitation in Veteran Cancer Survivors with Chronic Pain

> **NIH VA I21** · BALTIMORE VA MEDICAL CENTER · 2022 · —

## Abstract

Veterans are at a higher risk for lung cancer and so early detection, treatment, and symptom
management are critical. Treatment for lung cancer in those with early stage local disease includes surgery
and chemotherapy. However, persistent or chronic neuropathic pain, either post-thoracotomy persistent pain
(PTPP) or chemotherapy-induced peripheral neuropathy (CIPN) occurs in a majority of patients. Thus, not only
is this neuropathic pain widespread; there is no way to prevent its development, and long-term use of opioids
for control of symptoms could result in addiction. Ultimately, PTPP and CIPN can lead to long-term suffering
and disability during the post-treatment phase.
 Exercise, a non-pharmacologic intervention, holds promise as a new modality for reducing treatment-
related neuropathic pain and functional decline resulting from PTPP and CIPN. There is very limited research
examining the effects of exercise rehabilitation in those who have undergone lung resection for non-small cell
lung cancer (NSCLC), which represents about 85% of lung cancer cases. Engaging cancer survivors with
chronic post-surgical or post-chemotherapy neuropathic pain in this SPiRE meets a unique VA SPiRE directive
and serves an understudied population. [We hypothesize that lung cancer survivors with chronic pain have
reduced fitness and strength, poor muscle quality, and high levels of fatigue. Our global hypothesis is that
activity rehabilitation will reduce pain symptoms; which will be associated with improved fitness, functional
mobility, and reduced fatigue in lung cancer survivors with chronic pain compared to a delayed entry control
period. Twenty-seven Veterans with a NSCLC history and either PTPP or CIPN will be enrolled in a 6-week
delayed entry control period + 6-week VA Maryland Health Care System (VAMHCS) supervised exercise
rehabilitation program.]
Specific Aims:
[1) To determine the feasibility of conducting an exercise rehabilitation intervention in Veterans with NSCLC
and PTPP or CIPN.
2) To determine the effects of a VAMHCS-supervised activity rehabilitation program on chronic pain and
sensory thresholds (thermal, static, and dynamic) compared to delayed control.
3) To assess changes in fitness, strength, physical function, fatigue, and quality of life (QoL) after activity-
based rehabilitation compared to control period.]
This is the first project of its kind and the potential impact of this research is large, because exercise training
will be a prescription and the first approach for which NSCLC survivors can self-manage chronic neuropathic
pain. The ultimate goal of our work is to reduce neuropathic pain for the growing population of cancer survivors
while simultaneously reducing the need for problematic pharmacologic management. Therefore, results of this
study have potential for high impact on symptom care because it will allow effective neuropathic pain treatment
to be in full control of the Veteran, and likely restore function that is lost du...

## Key facts

- **NIH application ID:** 10489250
- **Project number:** 5I21RX002870-04
- **Recipient organization:** BALTIMORE VA MEDICAL CENTER
- **Principal Investigator:** ALICE S. RYAN
- **Activity code:** I21 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2022
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2018-12-01 → 2022-11-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10489250

## Citation

> US National Institutes of Health, RePORTER application 10489250, Progressive Activity-Based Rehabilitation in Veteran Cancer Survivors with Chronic Pain (5I21RX002870-04). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10489250. Licensed CC0.

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