Integrative Supportive Care Trial to Enhance physical Activity in Malignant pleural effusion (The Australasian Malignant PLeural Effusion (AMPLE)-5 Trial)

Integrated Supportive Care Program Participants will attend integrated supportive care program at week 1, week 4, and week 8. Multidisciplinary treatment of individualised care plans will be delivered by accredited dieticians, exercise physiologists/physiotherapists, and clinical psychologist/specially trained nurse. Prior to each appointment participants will complete a needs assessment screening to assess psychological distress, physical activity participation and nutritional status. Prior to each appointment the mulitdisciplinary team will discuss a plan. At each appointment participants will receive individual consultations with the each of the multidisciplinary team (e.g., nurse, dietitian, exercise physiologist/physiotherapist). Visits will be completed by tele-health (either by video-conference software, audio/teleconsult) or in-person appointment if required. Visits with each specialist will be up-to 20 minutes (up to 60 minutes total for the participants). (1) Dietetics: Nutrition counselling involves the provision of personalized recommendations for increasing energy and protein intake using normal food, and oral nutrition supplements (i.e., ‘high energy, high protein’ drinks) when required. 2) Psychology. Psychological counselling will include review of distress and psychological needs and implementing a plan to specifically identify and refer to appropriate support services for psychosocial care. At subsequent counselling sessions this plan will be re-evaluating and adjusted the plan as appropriate. This will be delivered by a nurse with specialist experience in malignant pleural effusion. 3) Physical Activity. Exercise counselling involves the provision of personalized recommendations for increasing physical activity participation (or maintaining participation as appropriate), and reducing sedentary time, and breaking up sedentary time. will include education, identification of appropriate programs and resources (e.g., Cancer Council WA Life Now program, or neighbourhood walking trails), behavioural support (e.g., goal setting, planning, identification of barriers and facilitators for physical activity), and tools for managing symptoms during physical activity, and suggestions for reducing sedentary time. Participants will be provided with the ‘Cancer Council WA Exercise for People Living with Cancer, A guide for people with cancer, their families and friends’. Adherence will be monitored by session attendance checklist.