Supportive Care in Cancer

, Volume 13, Issue 11, pp 929–937 | Cite as

Oncologists’ opinions towards recommending exercise to patients with cancer: a Canadian national survey

  • Lee W. Jones
  • Kerry S. Courneya
  • Carolyn Peddle
  • John R. Mackey
Original Article



The goal of this study was to examine oncologists’ attitudes towards recommending exercise to patients with cancer during treatment.

Patients and methods

Using a national survey, all 659 practicing medical and radiation oncologists in Canada were sent a brief questionnaire.


The response rate was 46% (281/610). The majority of oncologists agreed that exercise was beneficial (62.0%), important (55.8%) and safe (63.1%) for patients with cancer during treatment. Forty-three percent of oncologists reported that they tried to recommend exercise to their patients when appropriate. Moreover, oncologists actually reported recommending exercise to 28% of their patients during the past month. Analyses also indicated significant differences between oncologists, with younger, female, and medical oncologists generally having more favorable attitudes towards exercise for patients with cancer than their older, male, and radiation oncology counterparts.


Oncologists have a favorable attitude toward recommending exercise to patients with cancer although several important barriers may prevent oncologists from providing exercise advice to their patients. Further research is required evaluating the effectiveness of interventions and strategies designed to improve oncologists’ confidence and ability to advise their patients on exercise during oncology consultations.


Oncologist attitudes Exercise Survey 



This study was supported by a Research Team Grant from the National Cancer Institute of Canada (NCIC) with funds from the Canadian Cancer Society (CCS) and the CCS/NCIC Sociobehavioral Cancer Research Network (SCRN).


  1. 1.
    Courneya KS, Mackey JR, Bell GJ, Jones LW, Field CJ, Fairey AS (2003) Randomized controlled trial of exercise training in postmenopausal breast cancer survivors: cardiopulmonary and quality of life outcomes. J Clin Oncol 21(9):1660–1668CrossRefPubMedGoogle Scholar
  2. 2.
    MacVicar MG, Winningham ML (1986) Promoting functional capacity of cancer patients. Cancer Bull 38:235–239Google Scholar
  3. 3.
    MacVicar MG, Winningham ML, Nickel JL (1989) Effects of aerobic interval training on cancer patients’ functional capacity. Nurs Res 38:348–351Google Scholar
  4. 4.
    Fairey AS, Courneya KS, Field CJ, Bell GJ, Jones LW, Mackey JR (2003) Effects of exercise training on fasting insulin, insulin resistance, insulin-like growth factors, and insulin-like growth factor binding proteins in postmenopausal breast cancer survivors: a randomized controlled trial. Cancer Epidemiol Biomark Prev 12(8):721–727Google Scholar
  5. 5.
    Winningham ML, MacVicar MG, Bondoc M, Andrerson JI, Minton JP (1989) Effect of aerobic exercise on body weight and composition in patients with breast cancer on adjuvant chemotherapy. Oncol Nurs Forum 16:683–689Google Scholar
  6. 6.
    Segal R, Evans W, Johnson D, Smith J, Colletta S, Gayton J et al (2001) Structured exercise improves physical functioning in women with stages I and II breast cancer: results of a randomized controlled trial. J Clin Oncol 19(3):657–665PubMedGoogle Scholar
  7. 7.
    Schwartz AL (2000) Exercise and weight gain in breast cancer patients receiving chemotherapy. Cancer Pract 8(5):231–237CrossRefPubMedGoogle Scholar
  8. 8.
    Schwartz AL (1999) Fatigue mediates the effects of exercise on quality of life. Qual Life Res 8(6):529–538Google Scholar
  9. 9.
    Mock V, Pickett M, Ropka ME, Muscari Lin E, Stewart KJ, Rhodes VA, et al (2001) Fatigue and quality of life outcomes of exercise during cancer treatment. Cancer Pract 9(3):119–127CrossRefPubMedGoogle Scholar
  10. 10.
    Mock V, Dow KH, Meares CJ, Grimm PM, Dienemann JA, Haisfield-Wolfe ME et al (1997) Effects of exercise on fatigue, physical functioning, and emotional distress during radiation therapy for breast cancer. Oncol Nurs Forum 24(6):991–1000PubMedGoogle Scholar
  11. 11.
    Winningham ML, MacVicar MG (1988) The effect of aerobic exercise on patient reports of nausea. Oncol Nurs Forum 15(4):447–450Google Scholar
  12. 12.
    Eden KB, Orleans CT, Mulrow CD, Pender NJ, Teutsch SM (2002) Does counseling by clinicians improve physical activity? A summary of the evidence for the U.S. Preventive Services Task Force. Ann Intern Med 137(3):208–215Google Scholar
  13. 13.
    Jones LW, Courneya KS (2002) Exercise discussions during cancer treatment consultations. Cancer Pract 10(2):66–74CrossRefPubMedGoogle Scholar
  14. 14.
    Segar ML, Katch VL, Roth RS, Garcia AW, Portner TI, Glickman SG et al (1998) The effect of aerobic exercise on self-esteem and depressive and anxiety symptoms among breast cancer survivors. Oncol Nurs Forum 25(1):107–113PubMedGoogle Scholar
  15. 15.
    Jones LW, Courneya KS, Fairey AS, Mackey JR (2004) Effects of an oncologist’s recommendation to exercise on self-reported exercise behavior in newly diagnosed breast cancer survivors: a single-blind, randomized controlled trial. Ann Behav Med 28:105–113Google Scholar
  16. 16.
    Jones LW, Courneya KS (2002) Exercise counseling and programming preferences of cancer survivors. Cancer Pract 10(4):208–215CrossRefPubMedGoogle Scholar
  17. 17.
    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(3):674–684Google Scholar
  18. 18.
    Courneya KS, Blanchard CM, Laing DM (2001) Exercise adherence in breast cancer survivors training for a dragon boat race competition: a preliminary investigation. Psychooncology 10(5):444–452Google Scholar
  19. 19.
    Courneya KS, Friedenreich CM (1999) Utility of the theory of planned behavior for understanding exercise during breast cancer treatment. Psychooncology 8(2):112–122Google Scholar
  20. 20.
    Dillman DA (2000) Mail and internet surveys: the tailored design method. Wiley, New YorkGoogle Scholar
  21. 21.
    Edwards P, Roberts I, Clarke M, DiGuiseppi C, Pratap S, Wentz R et al (2002) Increasing response rates to postal questionnaires: systematic review. Br Med J 324(7347):1183Google Scholar
  22. 22.
    Ajzen I (1991) The theory of planned behavior. Organ Behav Hum Decis Process 50:179–211Google Scholar
  23. 23.
    Chen X, Siu LL (2001) Impact of the media and the internet on oncology: survey of cancer patients and oncologists in Canada. J Clin Oncol 19(23):4291–4297Google Scholar
  24. 24.
    Helft PR, Hlubocky F, Daugherty CK (2003) American oncologists’ views of internet use by cancer patients: a mail survey of American Society of Clinical Oncology members. J Clin Oncol 21(5):942–947Google Scholar
  25. 25.
    Bull FC, Schipper EC, Jamrozik K, Blanksby BA (1995) Beliefs and behaviour of general practitioners regarding promotion of physical activity. Aust J Public Health 19(3):300–304Google Scholar
  26. 26.
    Bull FC, Schipper EC, Jamrozik K, Blanksby BA (1997) How can and do Australian doctors promote physical activity? Prev Med 26(6):866–873Google Scholar
  27. 27.
    Godin G, Jobin J, Bouillon J (1986) Assessment of leisure time exercise behavior by self-report: a concurrent validity study. Can J Public Health 77(5):359–362PubMedGoogle Scholar
  28. 28.
    Godin G, Shephard RJ (1985) A simple method to assess exercise behavior in the community. Can J Appl Sport Sci 10(3):141–146PubMedGoogle Scholar
  29. 29.
    Pate RR, Pratt M, Blair SN, Haskell WL, Macera CA, Bouchard C et al (1995) Physical activity and public health. A recommendation from the Centers for Disease Control and Prevention and the American College of Sports Medicine. JAMA 273(5):402–407CrossRefPubMedGoogle Scholar
  30. 30.
    Young-McCaughan S, Sexton DL (1991) A retrospective investigation of the relationship between aerobic exercise and quality of life in women with breast cancer. Oncol Nurs Forum 18(4):751–757Google Scholar
  31. 31.
    Wee CC, McCarthy EP, Davis RB, Phillips RS (1999) Physician counseling about exercise. JAMA 282(16):1583–1588Google Scholar
  32. 32.
    Belardinelli R, Georgiou D, Cianci G, Purcaro A (1999) Randomized, controlled trial of long-term moderate exercise training in chronic heart failure: effects on functional capacity, quality of life, and clinical outcome. Circulation 99(9):1173–1182Google Scholar
  33. 33.
    Gielen S, Erbs S, Linke A, Mobius-Winkler S, Schuler G, Hambrecht R (2003) Home-based versus hospital-based exercise programs in patients with coronary artery disease: effects on coronary vasomotion. Am Heart J 145(1):E3Google Scholar
  34. 34.
    Blair SN, Kohl HW III, Paffenbarger RS Jr, Clark DG, Cooper KH, Gibbons LW (1989) Physical fitness and all-cause mortality. A prospective study of healthy men and women. JAMA 262(17):2395–2401Google Scholar
  35. 35.
    Myers J, Prakash M, Froelicher V, Do D, Partington S, Atwood JE (2002) Exercise capacity and mortality among men referred for exercise testing. N Engl J Med 346(11):793–801CrossRefPubMedGoogle Scholar
  36. 36.
    Gulati M, Pandey DK, Arnsdorf MF, Lauderdale DS, Thisted RA, Wicklund RH et al (2003) Exercise capacity and the risk of death in women: the St James Women Take Heart Project. Circulation 108(13):1554–1559Google Scholar
  37. 37.
    Segal R, Reid RD, Courneya KS, Malone SC, Parliament MB, Scott CG et al (2003) Resistance exercise in men receiving androgen deprivation therapy for prostate cancer. J Clin Oncol 21(9):1653–1659CrossRefPubMedGoogle Scholar
  38. 38.
    McKenzie DC, Kalda AL (2003) Effect of upper extremity exercise on secondary lymphedema in breast cancer patients: a pilot study. J Clin Oncol 21(3):463–466Google Scholar
  39. 39.
    Brown JK, Byers T, Doyle C, Coumeya KS, Demark-Wahnefried W, Kushi LH et al (2003) Nutrition and physical activity during and after cancer treatment: an American Cancer Society guide for informed choices. CA Cancer J Clin 53(5):268–291Google Scholar
  40. 40.
    Courneya KS, Friedenreich CM (1997) Relationship between exercise pattern across the cancer experience and current quality of life in colorectal cancer survivors. J Altern Complement Med 3:215–226PubMedGoogle Scholar
  41. 41.
    Wyatt GK, Friedman LL, Given CW, Given BA, Beckrow KC (1999) Complementary therapy use among older cancer patients. Cancer Pract 7(3):136–144CrossRefPubMedGoogle Scholar
  42. 42.
    Cooper-Patrick L, Gallo JJ, Gonzales JJ, Vu HT, Powe NR, Nelson C et al (1999) Race, gender, and partnership in the patient–physician relationship. JAMA 282(6):583–589CrossRefPubMedGoogle Scholar
  43. 43.
    Henderson JT, Weisman CS (2001) Physician gender effects on preventive screening and counseling: an analysis of male and female patients’ health care experiences. Med Care 39(12):1281–1292Google Scholar
  44. 44.
    Hyodo I, Eguchi K, Nishina T, Endo H, Tanimizu M, Mikami I et al (2003) Perceptions and attitudes of clinical oncologists on complementary and alternative medicine: a nationwide survey in Japan. Cancer 97(11):2861–2868CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 2005

Authors and Affiliations

  • Lee W. Jones
    • 1
  • Kerry S. Courneya
    • 2
  • Carolyn Peddle
    • 2
  • John R. Mackey
    • 3
  1. 1.Department of MedicineDuke University Medical CenterDurhamUSA
  2. 2.Faculty of Physical EducationUniversity of AlbertaEdmontonCanada
  3. 3.Department of Medical OncologyCross Cancer InstituteEdmontonCanada

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