Advances in lung cancer therapy are helping more patients live for years with metastatic disease, but the article argues that survival alone is not enough. Doctors and rehabilitation specialists say care must now also focus on daily functioning, fatigue, muscle loss, anxiety, depression, and the needs of families.
Dr. Shani Shilo, founder and CEO of the Israeli Lung Cancer Association, says prolonged survival means patients must cope longer with side effects, repeated scans, and treatment changes. She notes that in oncology, doctors track tumor size and metastases, but patients also live with the disease every day. She also says the toll on a patient affects the whole family, and that rehabilitation should not be treated as a luxury.
The Health Ministry reinforced that approach in May, issuing updated physiotherapy guidance that describes rehabilitation as an integral part of medical treatment, not an add-on. The recommendations stress personalized care, continuity, early intervention, and support for both patients and relatives. Yet Shilo says major gaps remain, especially for people with metastatic lung cancer, who often are not eligible for respiratory rehabilitation and, even when they are, struggle to find appointments because of severe shortages.
To address that gap, the association launched “Nashim LaRevacha” (“Breathing Easy”) with support from AstraZeneca as part of the global Lung Ambition initiative. The pilot enrolled 50 metastatic lung cancer patients in two rounds of 25 through the Facebook group “Friends for Breath,” with professional input from Dr. Dymian Urban, Prof. Alona Zer, and Dr. Amir Bar-Shai. Each participant received four one-on-one physiotherapy sessions, a tailored booklet, equipment, and three online emotional-support meetings for patients and caregivers. The program focused on aerobic exercise and strengthening, and the results, presented at ASCO and ESMO, showed improved physical function and general health, less fatigue, nausea, vomiting, and loss of appetite, with gains in strength and aerobic capacity. Shilo said the next step is to turn the program into a digital platform so more patients can keep the benefits longer.
