The average age of the approximately 228,000 Americans who will be diagnosed with lung cancer this year is 70, according to the American Cancer Society. &ldquo;Historically, older patients with cancer have been under-studied and they participate in clinical trials at a much lower rate than younger adults,&rdquo; says Carolyn Presley, MD, MHS, an OSUCCC &ndash; James assistant professor and thoracic (lung) cancer oncologist who also specializes in geriatric oncology. Presley is determined to change this research paradigm. Her lab is a national leader in the growing field of geriatric oncology and has initiated several clinical trials designed to &ldquo;maintain and improve the function of older adults with lung cancer and help them become more resilient during their treatment,&rdquo; she says. Presley&rsquo;s research focuses on how physical therapy, exercise, relaxation therapy and, most recently, diet, can improve the effectiveness of treatments and the ability of older patients to function and enjoy life to the fullest during and after their cancer treatment. She is also one of the leaders of The James Cancer and Aging Resiliency (CARE) clinic, a multidisciplinary clinic that addresses the unique needs of older adults with cancer. The FITNESS clinical trial Every patient is unique, so Ohio State researchers conduct an ongoing clinical trial called FITNESS that assesses the physical, mental and cognitive health of individuals at The James. &ldquo;The goal is to determine who is at a higher risk to develop toxicity from their treatment,&rdquo; Presley says of the clinical trial initiated by her collaborator and colleague Ashley Rosko, MD. The goal is to collect the initial data needed to apply for and receive a larger grant from a national organization and then enroll more patients in the next phase, and to include other cancer centers. A virtual clinical trial Resiliency Among Older Adults Receiving Lung Cancer Treatment (ROAR-LCT) is a unique clinical trial in that it includes a virtual component that allows patients to participate from home. ROAR features two components: exercise under the guidance of a James physical therapist, and relaxation exercises from a specialist in that type of therapy. &ldquo;Typically, I see patients every three weeks in my clinic,&rdquo; Presley explains. &ldquo;When they come in, they&rsquo;ll also do the exercise and relaxation components of ROAR. It can be hard for patients to come to The James every week, so, this way, they can log into their Ohio State MyChart online portal and have a one-on-one session with one of our specialists from the patient&rsquo;s own home.&rdquo; Patients who don&rsquo;t have a smart phone or home computer and internet access will be provided with a tablet with data service. &ldquo;We&rsquo;re still learning about the impact of physical activity and relaxation and how they can boost your immune system or perhaps even help immunotherapy work more effectively,&rdquo; Presley says. &ldquo;We know stress suppresses the immune system.&rdquo; Overcoming weight loss As many as 70 percent of lung cancer patients lose weight and become malnourished. &ldquo;Cancer can take all your energy and calories and change your metabolism, and when you combine with patients losing their appetite and just not wanting to eat, it can become a problem,&rdquo; Presley says. To turn this around, Colleen Spees, PhD, RD, and Presley will lead a new clinical trial, &ldquo;Nutricare&rdquo; in which patients will be given medically-tailored meals along with intensive nutritional counseling and special, home-delivered meals for at-risk patients. In addition, Presley leads a pharmaceutical trial testing a new drug by Helsinn pharmaceuticals that Presley said could improve the appetite of patients and alter their metabolism to help with weight gain. Other clinical trials The James sees more than 1400 lung cancer patients a year, Presley says, making it one of the largest thoracic clinics in the country. This scale &ldquo;means we can offer patients all the latest treatments and clinical trial options,&rdquo; she says. Other James clinical trials offer new immunotherapy treatments, as well as an investigation of when and how to combine chemotherapy and immunotherapy, and in what sequence. &ldquo;Less than 10 percent of patients who are 70 and older participate in clinical trials nationally, and the majority of the patients we treat are over 70,&rdquo; Presley says. &ldquo;They&rsquo;re chronically under-represented in clinical trials and we&rsquo;re working to change that.&rdquo; Motivated to care The issues and struggles of older patients are what inspired Presley to become a leader in the emerging field of geriatric lung cancer oncology. &ldquo;My exceptional colleagues at The James are working to develop the next generation of drugs that will cure and extend the lives of lung cancer patients,&rdquo; she says. &ldquo;In the meantime, people like me are working to support these patients and intervene in ways that help them live better and longer and function better. That&rsquo;s what drives me every day to try and push the needle forward.&rdquo; To learn more about lung cancer treatment or clinical trials at the OSUCCC &ndash; James, visit cancer.osu.edu/lungcancer or call 1-800-293-5066.