A new survey of patients treated for cancer in 12 hospitals finds that as many as 75% of patients report reducing their physical activity levels following a cancer diagnosis, despite its proven benefits. Psychological barriers such as difficulty getting motivated and remaining disciplined, along with fatigue and pain associated with cancer treatment, were identified as factors contributing to decreased activity. The findings, which will be presented at the upcoming 2017 Cancer Survivorship Symposium in San Diego, suggest new methods are needed to support and facilitate physical activity throughout the cancer care continuum.
While physical activity has long been considered an important element of cancer prevention and risk reduction, emerging data demonstrates the value of physical activity on quality of life for patients undergoing active treatment.
“Many people associate cancer treatment with needing to rest, but we’re learning that moderate forms of physical activity can not only help patients feel better generally but also, in some cases, potentially improve their cancer outcomes,” said lead author Sally A.D. Romero, PhD, a postdoctoral research fellow at Memorial Sloan Kettering Cancer Center. “Our research sheds light on the reasons patients are unable to achieve their exercise and physical activity goals. We found that psychological factors – such as motivation and discipline – were associated with a decrease in physical activity.”
Drs. Romero, Jun J. Mao, and colleagues conducted a one-time survey among 662 patients with common cancers who were being treated at Philadelphia area facilities. The majority of survey respondents were white females who were 60 years old on average. In addition, 65% of all survey respondents reported being overweight or obese.
Researchers found that 75% of survey respondents reported that they had decreased their physical activity levels since receiving a cancer diagnosis, while 16% maintained pre-diagnosis activity levels and 4% increased physical activity. For patients who reported barriers to physical activity, 71% said they had difficulty getting motivated, and 65% cited trouble remaining disciplined. Patients also reported more commonly known barriers to physical activity such as fatigue (78%) and pain (68%).
“The side effects of cancer treatment like fatigue and pain can be addressed relatively easily, but the other reasons patients aren’t exercising can be more complicated, and we need to focus on those as well,” Dr. Romero said. “Our challenge as providers is to help our patients think about physical activity in new ways, while personalizing their care.”
Researchers noted that many NCI-Designated Cancer Centers offer and are expanding exercise programs tailored to the unique needs of people with cancer and survivors. In addition, Dr. Romero emphasized that as cancer care teams expand to include fitness specialists and occupational and physical therapists, patient psychological barriers could be readily addressed and an exercise plan personalized to each patient. Authors said additional research is needed to better understand how clinicians and patients can work together to maintain physical activity levels during the cancer care continuum.
ASCO’s clinical practice guidelines recommend that providers encourage all patients to engage in a moderate level of physical activity after cancer treatment (e.g. 150 minutes of moderate aerobic exercise per week).