Effect of Pulmonary Rehabilitation on Surgical Outcomes in the Cancer Setting

Inclusion Criteria: 1. Patients with anatomically resectable lung tumors who are deemed surgically inoperable based on preoperative pulmonary function testing FEV1 \< 80% pred; DLCO \< 80% pred; FEV1ppo \< 40% pred; DLCO ppo \< 40% pred AND VO2 peak \< 60% predicted or \< 15 ml/kg/min. 2. Patients deemed surgically inoperable based on poor performance status (ECOG score 2-3) 3. Any non-pulmonary co-morbidity must be stable according to institutional guidelines. Exclusion Criteria: 1. Previously reported severe pulmonary hypertension (pulmonary artery systolic pressure \> 60 as determined by echocardiogram), refractory cor pulmonale (as manifested by right ventricular dilatation or dysfunction by echocardiogram) 2. Previously reported exercise-induced syncope, angina, palpitation, arrhythmia, hypotension (drop of 20% of systolic/diastolic from baseline) 3. History of severe congestive heart failure (NYHA class 3 and 4) refractory to medical management, (LVEF \< 40% by echocardiogram). 4. Bone metastasis 5. Active psychiatric illness that could interfere with treatment.