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Physical activity barriers, preferences, and beliefs in childhood cancer patients

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Abstract

Purpose

Childhood cancer patients report low physical activity levels despite the risk for long-term complications that may benefit from exercise. Research is lacking regarding exercise barriers, preferences, and beliefs among patients (1) on- and off-therapy and (2) across the age spectrum.

Methods

Cross-sectional study in the Yale Pediatric Hematology-Oncology Clinic (October 2013–October 2014). Participants were ≥ 4 years old, > 1 month after cancer diagnosis at < 20 years, not acutely ill, expected to live > 6 months, and received chemotherapy and/or radiation. Participants (or parents if < 13 years) completed a survey.

Results

The 162 patients (99% participated) were 34% children (4.0–12.9 years), 31% adolescents (13.0–17.9 years), and 35% adults (≥ 18 years). Most had leukemia/lymphoma (66%); 32% were on-therapy. On-therapy patients were more likely than off-therapy patients (73 vs. 48%; p = 0.003) to report ≥ 1 barrier related to physical complaints, such as “just too tired” (46 vs. 28%; p = 0.021) or “afraid” of injury (22 vs. 9%; p = 0.027). The majority preferred walking (73%), exercising at home (91%), exercising in the afternoon (79%), and a maximum travel time of 10–20 min (54%); preferences did not vary significantly by therapy status or age. Most respondents (94%) recognized the benefits of exercise after cancer, but 50% of on- vs. 12% of off-therapy patients believed “their cancer diagnosis made it unsafe to exercise regularly” (p < 0.001).

Conclusions

Physical activity barriers pertaining to physical complaints and safety concerns were more pronounced in on-therapy childhood cancer patients but persisted off-therapy. Preferences and beliefs were relatively consistent. Our data can inform interventions in different patient subgroups.

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Funding

This work was supported by a grant from the Hyundai Hope on Wheels Foundation.

Author information

Authors and Affiliations

  1. Section of Pediatric Hematology-Oncology, Yale School of Medicine, PO Box 208064, 333 Cedar Street, LMP-2073, New Haven, CT, 06520-8064, USA

    Wilhelmenia L. Ross, Alyssa Le, Daniel J. Zheng, Jaime Rotatori & Nina S. Kadan-Lottick

  2. Department of Medicine, Boston Children’s Hospital, Boston, MA, USA

    Daniel J. Zheng

  3. Department of Pediatrics, Boston Medical Center, Boston, MA, USA

    Daniel J. Zheng

  4. Department of Psychology, University of Miami, Coral Gables, FL, USA

    Hannah-Rose Mitchell

  5. Yale School of Public Health, New Haven, CT, USA

    Fangyong Li

  6. Yale Center for Analytical Sciences, New Haven, CT, USA

    Fangyong Li

  7. Section of Pediatric Cardiology, Yale School of Medicine, New Haven, CT, USA

    John T. Fahey

  8. Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN, USA

    Kirsten K. Ness

  9. Yale Cancer Center, New Haven, CT, USA

    Nina S. Kadan-Lottick

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  1. Wilhelmenia L. Ross
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Correspondence to Nina S. Kadan-Lottick.

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Ross, W.L., Le, A., Zheng, D.J. et al. Physical activity barriers, preferences, and beliefs in childhood cancer patients. Support Care Cancer 26, 2177–2184 (2018). https://doi.org/10.1007/s00520-017-4041-9

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