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Moving forward on all fronts: impact, patterns, and barriers to exercise in cancer survivors and patients living with advanced disease

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Abstract

Introduction

Exercise is recommended for all patients with cancer, but there has been limited study of exercise habits in patients across the spectrum of illness.

Purpose

This pragmatic survey aimed to identify the unmet supportive care needs, self-reported symptoms, and exercise habits among both cancer survivors and patients living with advanced disease to determine adherence to exercise guidelines and to identify barriers and opportunities to improve exercise.

Methods

An anonymous cross-sectional self-administered paper survey was distributed to patients with cancer presenting for oncology clinic visits at an academic cancer center. Survey measures included presence of symptoms and health problems in addition to weekly time spent exercising, change in exercise levels since diagnosis, interest in exercise, and self-reported barriers. Participants reporting at least 150 min of exercise per week were characterized as adherent to guidelines.

Results

Among 640 survey respondents, 570 (89%) completed questions about exercise. Only 44% of cancer survivors and 34% of patients living with advanced disease met current guidelines. Survivors who met exercise guidelines had a lower prevalence of fatigue and memory impairments, but this finding was not seen among patients with advanced cancer. Over 70% of patients with advanced disease and 47% of survivors reported decreasing exercise post-diagnosis compared to pre-diagnosis. Prominent barriers to exercise among both groups included burden of illness and time constraints but interest in increasing exercise was high.

Conclusions

There is an opportunity to improve exercise and related outcomes among a large percentage of both cancer survivors and patients living with advanced disease.

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Acknowledgments

The results of this study are presented clearly, honestly, and without fabrication, falsification, or inappropriate data manipulation. There are no financial relationships or conflicts of interest to disclose and this research was not funded by a grant or other interest. The corresponding and senior authors have full control over the primary data.

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Authors and Affiliations

  1. Spaulding Rehabilitation Hospital, Charlestown, MA, USA

    Sasha E. Knowlton

  2. Massachusetts General Hospital, Boston, MA, USA

    Sasha E. Knowlton, Elizabeth K. O’Donnell, Nora Horick, Giselle K. Perez, Elyse Park, Jessica Garton & Jeffrey M. Peppercorn

  3. Harvard Medical School, Boston, MA, USA

    Sasha E. Knowlton, Elizabeth K. O’Donnell, Giselle K. Perez & Jeffrey M. Peppercorn

  4. University of Cincinnati, Cincinnati, OH, USA

    Julia Rabin

  5. Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA

    Kit M. Quain

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  1. Sasha E. Knowlton
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Correspondence to Sasha E. Knowlton.

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Knowlton, S.E., O’Donnell, E.K., Horick, N. et al. Moving forward on all fronts: impact, patterns, and barriers to exercise in cancer survivors and patients living with advanced disease. Support Care Cancer 28, 4979–4988 (2020). https://doi.org/10.1007/s00520-020-05344-w

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  • DOI: https://doi.org/10.1007/s00520-020-05344-w

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