Abstract
Previous chapters have highlighted the importance of regular and sustained exercise across the cancer continuum. However, recent exercise prevalence figures indicate that the overwhelming majority of cancer survivors are not exercising at levels required for the accrual of health benefits. Therefore, Exercise and cancer researchers are faced with the challenge of developing effective strategies that motivate cancer survivors to initiate and sustain exercise behavior. This chapter provides an overview of (a) current exercise prevalence estimates among cancer survivors, (b) factors that motivate survivors to engage in regular and sustained exercise, (c) exercise maintenance (defined as continuing to engage in regular exercise for at least 6 months after the end of an intervention as reported by Vallance et al. (Am J Health Behav 34:225–236, 2010); Bock et al. (Ann Behav Med 23:79–87, 2001); van Stralen et al. (Health Educ Res 25:233–247, 2010)) after clinical exercise and exercise behavior change interventions for cancer survivors, (d) recommendations for examining exercise maintenance among cancer survivors, and (e) practical implications for health care providers. Understanding the factors that affect exercise behavior, motivation, and maintenance may help practitioners, researchers, and clinicians in developing effective exercise behavior maintenance programs for cancer survivors. Such programs are critical given the recent evidence suggesting that increased exercise may be associated with a lower risk of recurrence, cancer specific mortality, and all-cause mortality for breast and colon cancer survivors.
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References
Holick CN, Newcomb PA, Trentham-Dietz A et al (2008) Physical activity and survival after diagnosis of invasive breast cancer. Cancer Epidemiol Biomarkers Prev 17:379–386
Irwin ML, Smith AW, McTiernan A et al (2008) Influence of pre- and postdiagnosis physical activity on mortality in breast cancer survivors: the health, eating, activity, and lifestyle study. J Clin Oncol 26:3958–3964
Meyerhardt JA, Giovannucci EL, Holmes MD et al (2006) Physical activity and survival after colorectal cancer diagnosis. J Clin Oncol 24:3527–3534
Meyerhardt JA, Heseltine D, Niedzwiecki D et al (2006) Impact of physical activity on cancer recurrence and survival in patients with stage III colon cancer: findings from CALGB 89803. J Clin Oncol 24:3535–3541
Eakin EG, Youlden DR, Baade PD et al (2007) Health behaviors of cancer survivors: data from an Australian population-based survey. Cancer Causes Control 18:881–894
Blanchard CM, Courneya KS, Stein K, American Cancer Society’s SCS, II (2008) Cancer survivors’ adherence to lifestyle behavior recommendations and associations with health-related quality of life: results from the American Cancer Society’s SCS-II. J Clin Oncol 26:2198–2204
Courneya KS, Katzmarzyk PT, Bacon E (2008) Physical activity and obesity in Canadian cancer survivors: population-based estimates from the 2005 Canadian Community Health Survey. Cancer 112:2475–2482
Vallance J, Plotnikoff RC, Karvinen KH, Mackey JR, Courneya KS (2010) Understanding physical activity maintenance in breast cancer survivors. Am J Health Behav 34:225–236
Bock BC, Marcus BH, Pinto BM, Forsyth LH (2001) Maintenance of physical activity following an individualized motivationally tailored intervention. Ann Behav Med 23:79–87
van Stralen MM, Lechner L, Mudde AN, de Vries H, Bolman C (2010) Determinants of awareness, initiation and maintenance of physical activity among the over-fifties: a Delphi study. Health Educ Res 25:233–247
National Cancer Institute Office of Cancer Survivorship (2009) http://www.cancercontrol.cancer.gov/ocs/office-survivorship.html. Retrieved 5 Nov 2009
Demark-Wahnefried W, Peterson B, McBride C, Lipkus I, Clipp E (2000) Current health behaviors and readiness to pursue life-style changes among men and women diagnosed with early stage prostate and breast carcinomas. Cancer 88:674–684
Blanchard CM, Stein KD, Baker K et al (2004) Association between current lifestyle behaviours and health-related quality of life in breast, colorectal, and prostate cancer survivors. Psychol Health 19:1–13
Thorsen L, Skovlund E, Stromme SB et al (2005) Effectiveness of physical activity on cardiorespiratory fitness and health-related quality of life in young and middle-aged cancer patients shortly after chemotherapy. J Clin Oncol 23:2378–2388
Mayer DK, Terrin NC, Menon U et al (2007) Health behaviors in cancer survivors. Oncol Nurs Forum 34:643–651
Coups EJ, Ostroff JS (2005) A population-based estimate of the prevalence of behavioral risk factors among adult cancer survivors and noncancer controls. Prev Med 40:702–711
Rogers LQ, Courneya KS, Paragi-Gururaja R, Markwell SJ, Imeokparia R (2008) Lifestyle behaviors, obesity, and perceived health among men with and without a diagnosis of prostate cancer: a population-based, cross-sectional study. BMC Public Health 8:23
Schootman M, Deshpande AD, Pruitt SL, Aft R, Jeffe DB (2010) National estimates of racial disparities in health status and behavioral risk factors among long-term cancer survivors and non-cancer controls. Cancer Causes Control 21:1387–1395
Stevinson C, Faught W, Steed H et al (2007) Associations between physical activity and quality of life in ovarian cancer survivors. Gynecol Oncol 106:244–250
Vallance JK, Courneya KS, Jones LW, Reiman T (2005) Differences in quality of life between non-Hodgkin’s lymphoma survivors meeting and not meeting public health exercise guidelines. Psychooncology 14:979–991
Vallance JK, Lavallee CM, Culos-Reed NS, Trudeau MG (2012) Physical activity is associated with clinically important differences in health-related quality of life among rural and small-town breast cancer survivors. Support Care Cancer 20(5):1079–1087
Irwin ML, Crumley D, McTiernan A et al (2003) Physical activity levels before and after a diagnosis of breast carcinoma: the Health, Eating, Activity, and Lifestyle (HEAL) study. Cancer 97:1746–1757
Lynch BM, Dunstan DW, Healy GN et al (2010) Objectively measured physical activity and sedentary time of breast cancer survivors, and associations with adiposity: findings from NHANES (2003–2006). Cancer Causes Control 21:283–288
Lynch BM, Dunstan DW, Winkler E et al (2011) Objectively assessed physical activity, sedentary time and waist circumference among prostate cancer survivors: findings from the National Health and Nutrition Examination Survey (2003–2006). Eur J Cancer Care (England) 20:514–519
Colley RC, Garriguet D, Janssen I et al (2011) Physical activity of Canadian adults: accelerometer results from the 2007 to 2009 Canadian Health Measures Survey. Health Rep 22:7–14
Troiano RP, Berrigan D, Dodd KW et al (2008) Physical activity in the United States measured by accelerometer. Med Sci Sports Exerc 40:181–188
Jones LW, Guill B, Keir ST et al (2007) Exercise interest and preferences among patients diagnosed with primary brain cancer. Support Care Cancer 15:47–55
Karvinen KH, Courneya KS, Venner P, North S (2007) Exercise programming and counseling preferences in bladder cancer survivors: a population-based study. J Cancer Surviv 1:27–34
Rogers LQ, Markwell SJ, Courneya KS, McAuley E, Verhulst S (2009) Exercise preference patterns, resources, and environment among rural breast cancer survivors. J Rural Health 25:388–391
Stevinson C, Capstick V, Schepansky A et al (2009) Physical activity preferences of ovarian cancer survivors. Psychooncology 18:422–428
Vallance JK, Courneya KS, Jones LW, Reiman T (2006) Exercise preferences among a population-based sample of non-Hodgkin’s lymphoma survivors. Eur J Cancer Care (England) 15:34–43
Courneya KS, Friedenreich CM (1997) Determinants of exercise during colorectal cancer treatment: an application of the theory of planned behavior. Oncol Nurs Forum 24:1715–1723
Courneya KS, Friedenreich CM (1999) Utility of the theory of planned behavior for understanding exercise during breast cancer treatment. Psychooncology 8:112–122
Karvinen KH, Courneya KS, Campbell KL et al (2006) Exercise preferences of endometrial cancer survivors: a population-based study. Cancer Nurs 29:259–265
Rogers LQ, Courneya KS, Verhulst S, Markwell SJ, McAuley E (2008) Factors associated with exercise counseling and program preferences among breast cancer survivors. J Phys Act Health 5:688–705
Keats MR, Culos-Reed SN, Courneya KS, McBride M (2007) Understanding physical activity in adolescent cancer survivors: an application of the theory of planned behavior. Psychooncology 16:448–457
Wilkinson AV, Barrera SL, McBride CM et al (2010) Extant health behaviors and uptake of standardized vs tailored health messages among cancer survivors enrolled in the FRESH START trial: a comparison of fighting-spirits vs fatalists. Psychooncology 21(1):108–113
Ajzen I (1991) The theory of planned behavior. Organ Behav Hum Decis Process 50:179–211
Bandura A (2000) Health promotion from the perspective of social cognitive theory. Harwood Academic, Amsterdam
Courneya KS, Vallance JK, Jones LW, Reiman T (2005) Correlates of exercise intentions in non-Hodgkin’s lymphoma survivors: an application of the theory of planned behavior. J Sport Exerc Psychol 27:335–349
Stevinson C, Tonkin K, Capstick V et al (2009) A population-based study of the determinants of physical activity in ovarian cancer survivors. J Phys Act Health 6:339–346
Karvinen KH, Courneya KS, Plotnikoff RC et al (2009) A prospective study of the determinants of exercise in bladder cancer survivors using the theory of planned behavior. Support Care Cancer 17:171–179
Karvinen KH, Courneya KS, Campbell KL et al (2007) Correlates of exercise motivation and behavior in a population-based sample of endometrial cancer survivors: an application of the theory of planned behavior. Int J Behav Nutr Phys Act 4:21
Trinh L, Plotnikoff RC, Rhodes RE, North S, Courneya KS (2011) Associations between physical activity and quality of life in a population-based sample of kidney cancer survivors. Cancer Epidemiol Biomarkers Prev 20:859–868
Gollwitzer PM (1999) Implementation intentions: strong effects of simple plans. Am Psychol 54(7):493–503
Luszczynska A (2006) An implementation intentions intervention, the use of a planning strategy, and physical activity after myocardial infarction. Soc Sci Med 62:900–908
Pinto BM, Maruyama NC, Clark MM et al (2002) Motivation to modify lifestyle risk behaviors in women treated for breast cancer. Mayo Clin Proc 77:122–129
Rogers LQ, Courneya KS, Verhulst S et al (2006) Exercise barrier and task self-efficacy in breast cancer patients during treatment. Support Care Cancer 14:84–90
Rogers LQ, McAuley E, Courneya KS, Verhulst SJ (2008) Correlates of physical activity self-efficacy among breast cancer survivors. Am J Health Behav 32:594–603
Rogers LQ, Shah P, Dunnington G et al (2005) Social cognitive theory and physical activity during breast cancer treatment. Oncol Nurs Forum 32:807–815
Coups EJ, Park BJ, Feinstein MB et al (2009) Correlates of physical activity among lung cancer survivors. Psychooncology 18:395–404
Pinto BM, Ciccolo JT (2011) Physical activity motivation and cancer survivorship. Recent Results Cancer Res 186:367–387
Demark-Wahnefried W, Pinto BM, Gritz ER (2006) Promoting health and physical function among cancer survivors: potential for prevention and questions that remain. J Clin Oncol 24:5125–5131
Aziz NM (2002) Cancer survivorship research: challenge and opportunity. J Nutr 132:3494s–3503s
Hewitt M, Greenfield S, Stovall E (eds) (2006) From cancer patient to cancer survivor: lost in transition. National Academies Press, Washington
Eakin EG, Youlden DR, Baade PD et al (2006) Health status of long-term cancer survivors: results from an Australian population-based sample. Cancer Epidemiol Biomarkers Prev 15:1969–1976
Fjeldsoe B, Neuhaus M, Winkler E, Eakin E (2011) Systematic review of maintenance of behavior change following physical activity and dietary interventions. Health Psychol 30:99–109
Brantley P, Appel L, Hollis L et al (2008) Design considerations and rationale of a multi-center trial to sustain weight loss: the weight loss maintenance trial. Clin Trials 5:546–556
Barte JC, ter Bogt NC, Bogers RP et al (2010) Maintenance of weight loss after lifestyle interventions for overweight and obesity, a systematic review. Obes Rev 11:899–906
Gourlan MJ, Trouilloud DO, Sarrazin PG (2011) Interventions promoting physical activity among obese populations: a meta-analysis considering global effect, long-term maintenance, physical activity indicators and dose characteristics. Obes Rev 12(7):e633–e645
Turk MW, Yang K, Hravnak M et al (2009) Randomized clinical trials of weight loss maintenance: a review. J Cardiovasc Nurs 24:58–80
Gerber BS, Stolley MR, Thompson AL, Sharp LK, Fitzgibbon ML (2009) Mobile phone text messaging to promote healthy behaviors and weight loss maintenance: a feasibility study. Health Inf J 15:17–25
Riebe D, Blissmer B, Greene G et al (2005) Long-term maintenance of exercise and healthy eating behaviors in overweight adults. Prev Med 40:769–778
Wing RR, Papandonatos G, Fava JL et al (2008) Maintaining large weight losses: the role of behavioral and psychological factors. J Consult Clin Psychol 76:1015–1021
Tate DF, Jeffery RW, Sherwood NE, Wing RR (2007) Long-term weight losses associated with prescription of higher physical activity goals. Are higher levels of physical activity protective against weight regain? Am J Clin Nutr 85:954–959
Eakin EG, Lawler SP, Vandelanotte C, Owen N (2007) Telephone interventions for physical activity and dietary behavior change - a systematic review. Am J Prev Med 32:419–434
Vallance JK, Courneya KS, Plotnikoff RC, Dinu I, Mackey JR (2008) Maintenance of physical activity in breast cancer survivors after a randomized trial. Med Sci Sports Exerc 40:173–180
Stull VB, Snyder DC, Demark-Wahnefried W (2007) Lifestyle interventions in cancer survivors: designing programs that meet the needs of this vulnerable and growing population. J Nutr 137:243s–248s
Speck RM, Courneya KS, Masse LC, Duval S, Schmitz KH (2010) An update of controlled physical activity trials in cancer survivors: a systematic review and meta-analysis. J Cancer Surviv 4:87–100
Mutrie N, Campbell AM, Whyte F et al (2007) Benefits of supervised group exercise programme for women being treated for early stage breast cancer: pragmatic randomised controlled trial. Br Med J 334:517–520B
Eakin EG, Lawler SP, Winkler EA, Hayes SC (2012) A randomized trial of a telephone-delivered exercise intervention for non-urban dwelling women newly diagnosed with breast cancer: exercise for health. Ann Behav Med 43:229–238
Morey MC, Snyder DC, Sloane R et al (2009) Effects of home-based diet and exercise on functional outcomes among older, overweight long-term cancer survivors: RENEW: a randomized controlled trial. JAMA 301:1883–1891
Vallance JK, Courneya KS, Plotnikoff RC, Yasui Y, Mackey JR (2007) Randomized controlled trial of the effects of print materials and step pedometers on physical activity and quality of life in breast cancer survivors. J Clin Oncol 25:2352–2359
Ottenbacher AJ, Day SR, Taylor WC et al (2012) Long-term physical activity outcomes of home-based lifestyle interventions among breast and prostate cancer survivors. Support Care Cancer Jan 17 (Epub ahead of print)
Pinto BM, Rabin C, Papandonatos GD et al (2008) Maintenance of effects of a home-based physical activity program among breast cancer survivors. Support Care Cancer 16:1279–1289
Marshall AL, Owen N, Bauman AE (2004) Mediated approaches for influencing physical activity: update of the evidence on mass media, print, telephone and website delivery of interventions. J Sci Med Sport 7:74–80
Schmitz KH, Holtzman J, Courneya KS et al (2005) Controlled physical activity trials in cancer survivors: a systematic review and meta-analysis. Cancer Epidemiol Biomarkers Prev 14:1588–1595
Kahn EB, Ramsey LT, Brownson RC et al (2002) The effectiveness of interventions to increase physical activity – a systematic review. Am J Prev Med 22:73–108
Rothman AJ, Sheeran P, Wood W (2009) Reflective and automatic processes in the initiation and maintenance of dietary change. Ann Behav Med 38(Suppl 1):S4–S17
van Stralen MM, De Vries H, Mudde AN, Bolman C, Lechner L (2009) Determinants of initiation and maintenance of physical activity among older adults: a literature review. Health Psychol 3:147–207
Holmes MD, Chen WY, Feskanich D, Kroenke CH, Colditz GA (2005) Physical activity and survival after breast cancer diagnosis. JAMA 293:2479–2486
Schmitz KH, Courneya KS, Matthews C et al (2010) American College of Sports Medicine Roundtable on Exercise Guidelines for Cancer Survivors. Med Sci Sports Exerc 42:1409–1426
Brunet J, Sabiston CM, Meterissian S (in press) Physical activity and breast cancer survivorship: best practice guidelines. Am J Lifestyle Med
Jakicic JM, Wing RR, Butler BA, Robertson RJ (1995) Prescribing exercise in multiple short bouts versus one continuous bout: effects on adherence, cardiorespiratory fitness, and weight loss in overweight women. Int J Obes Relat Metab Disord 19:893–901
Milne HM, Wallman KE, Guilfoyle A, Gordon S, Courneya KS (2008) Self-determination theory and physical activity among breast cancer survivors. J Sport Exerc Psychol 30:23–38
Courneya KS, Karvinen KH, Campbell KL et al (2005) Associations among exercise, body weight, and quality of life in a population-based sample of endometrial cancer survivors. Gynecol Oncol 97:422–430
Jones LW, Courneya KS, Vallance JK et al (2004) Association between exercise and quality of life in multiple myeloma cancer survivors. Support Care Cancer 12:780–788
Jones LW, Guill B, Keir ST et al (2006) Patterns of exercise across the cancer trajectory in brain tumor patients. Cancer 106:2224–2232
Karvinen KH, Courneya KS, North S, Venner P (2007) Associations between exercise and quality of life in bladder cancer survivors: a population-based study. Cancer Epidemiol Biomarkers Prev 16:984–990
Acknowledgements
Dr. Jeff Vallance is supported by a Population Health Investigator Salary Award from Alberta Innovates – Health Solutions and a New Investigator Award from the Canadian Institutes of Health Research. Lauren Spark is supported by an Australian Postgraduate Award. Dr. Elizabeth Eakin is supported by Senior Research Fellowship from the National Health and Medical Research Council (Australia).
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Vallance, J., Spark, L., Eakin, E. (2013). Exercise Behavior, Motivation, and Maintenance Among Cancer Survivors. In: Ulrich, C., Steindorf, K., Berger, N. (eds) Exercise, Energy Balance, and Cancer. Energy Balance and Cancer, vol 6. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-4493-0_13
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