Cancer survivors’ experiences of a community-based cancer-specific exercise programme: results of an exploratory survey

Original Article

Abstract

Purpose

Exercise levels often decline following cancer diagnosis despite growing evidence of its benefits. Treatment side effects, older age, lack of confidence and opportunity to exercise with others in similar circumstances influence this. Our study explored the experiences of people attending a cancer-specific community-based exercise programme (CU Fitter™).

Methods

A survey distributed to those attending the programme gathered demographic/clinical information, self-reported exercise levels, information provision and barriers to/benefits of exercise.

Results

Sixty surveys were evaluable from 65/100 returned (62% female, 68% > 60 years, 66% breast/prostate cancer). Most (68%) were receiving treatment. Sixty-eight percent attended classes once or twice weekly. Fifty-five percent received exercise advice after diagnosis, usually from their hospital doctor/nurse. More (73%) had read about exercising, but less used the Internet to source information (32%). Self-reported exercise levels were higher currently than before diagnosis (p = 0.05). Forty-eight percent said their primary barrier to exercising was the physical impact of cancer/treatment. Improving fitness/health (40%) and social support (16%) were the most important gains from the programme. Many (67%) had made other lifestyle changes and intented to keep (50%) or increase (30%) exercising.

Conclusions

This community-based cancer-specific exercise approach engaged people with cancer and showed physical, psychological, and social benefits.

Implications for cancer survivors

Community-grown exercise initiatives bring cancer survivors together creating their own supportive environment. Combining this with instructors familiar with the population and providing an open-ended service may prove particularly motivating and beneficial. Further work is required to provide evidence for this.

Keywords

Cancer Exercise Health behaviour Physical activity Quality of life Survivorship 

Notes

Acknowledgements

We would like to thank all the respondents who found time to complete the survey.

Compliance with ethical standards

Brighton and Sussex Medical School (BSMS) Research Governance and Ethics Committee (Ref No: 16/024/HAR) granted ethical approval for the study.

Conflict of interest

Susan Catt and Helena Harder have no conflicts of interest to declare. Jan Sheward and Erica Sheward are Trustees of Cancer United™ (No.1155747), a registered cancer support charity based in West Sussex, UK through which the CU Fitter™ programme is delivered.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

520_2018_4179_MOESM1_ESM.pdf (198 kb)
ESM 1 (PDF 198 kb)

References

  1. 1.
    Maddams J, Utley M, Møller H (2012) Projections of cancer prevalence in the United Kingdom, 2010-2040. Br J Cancer 107:1195–1202CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Santin O, Mills M, Treanor C, Donnelly MA (2012) Comparative analysis of the health and well-being of cancer survivors to the general population. Support Care Cancer 20:2545–2552CrossRefPubMedGoogle Scholar
  3. 3.
    Segal R, Zwaal C, Green E, Tomasone JR, Loblaw A, Petrella T (2017) Exercise for people with cancer: a systematic review. Curr Oncol 24:40–46Google Scholar
  4. 4.
    Stout NL, Baima J, Swisher AK, Winters-Stone KM, Welsh J (2017) A systematic review of exercise systematic reviews in the cancer literature (2005–2017). PM R 9:S347–S384CrossRefPubMedGoogle Scholar
  5. 5.
    Department of Health. UK Physical activity guidelines – Fact sheets 4 (adults 19–64 years) and 5 (older adults 65+ years). 2011. https://www.gov.uk/government/publications/uk-physical-activity-guidelines. Accessed 10 Aug 2017
  6. 6.
    Rock CL, Doyle C, Demark-Wahnefried W, Meyerhardt J, Courneya KS, Schwartz AL, Bandera ED, Hamilton KK, Grant B, McCullough M, Byers T, Gansler T (2012) Nutrition and physical activity guidelines for cancer survivors. CA Cancer J Clin 62:242–274CrossRefGoogle Scholar
  7. 7.
    Stevinson C, Lydon A, Amir Z (2014) Adherence to physical activity guidelines among cancer support group participants. Eur J Cancer Care 23:199–205CrossRefGoogle Scholar
  8. 8.
    Hawkins M, Buys S, Gren L, Simonsen S, Kirchhoff A, Hashibe M (2017) Do cancer survivors develop healthier lifestyle behaviors than the cancer-free population in the PLCO study? J Cancer Surviv 11:233–245CrossRefPubMedGoogle Scholar
  9. 9.
    Henriksson A, Arving C, Johansson B, Igelström H, Nordin K (2016) Perceived barriers to and facilitators of being physically active during adjuvant cancer treatment. Patient Educ Couns 99:1220–1226CrossRefPubMedGoogle Scholar
  10. 10.
    Arthur AE, Delk A, Demark-Wahnefried W, Christein JD, Contreras C, Posey JA III, Vickers S, Oster R, Rogers LQ (2016) Pancreatic cancer survivors’ preferences, barriers, and facilitators related to physical activity and diet interventions. J Cancer Surviv 10:981–989CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Granger CL, Connolly B, Denehy L, Hart N, Antippa P, Lin K-Y, Parry SM (2017) Understanding factors influencing physical activity and exercise in lung cancer: a systematic review. Support Care Cancer 25:983–999CrossRefPubMedGoogle Scholar
  12. 12.
    Smith L, Crocker H, Fisher A, Williams K, Wardle J, Beeken RJ (2017) Cancer survivors’ attitudes towards and knowledge of physical activity, sources of information, and barriers and facilitators of engagement: a qualitative study. Eur J Cancer Care 26.  https://doi.org/10.1111/ecc.12641
  13. 13.
    Clifford B, Mizrahi D, Sandler C, Barry B, Simar D, Wakefield C, Goldstein D (2018) Barriers and facilitators of exercise experienced by cancer survivors: a mixed methods systematic review. Support Care Cancer 26:685–700CrossRefPubMedGoogle Scholar
  14. 14.
    Cummins C, Kayes NM, Reeve J, Smith G, MacLeod R, McPherson KM (2017) Navigating physical activity engagement following a diagnosis of cancer: a qualitative exploration. Eur J Cancer Care 26.  https://doi.org/10.1111/ecc.12608
  15. 15.
    Kirkham A, Neil-Sztramko S, Morgan J, Hodson S, Weller S, McRae T, Campbell K (2016) Fee-for-service cancer rehabilitation programs improve health-related quality of life. Curr Oncol 23:233–240CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Godin G (2011) The Godin-Shephard leisure-time physical activity questionnaire. Health Fit J Can 4:18–22Google Scholar
  17. 17.
    Amireault S, Godin G (2015) The Godin-Shephard leisure-time physical activity questionnaire: validity evidence supporting its use for classifying healthy adults into active and insufficiently active categories. Percept Mot Skills 120:604–622CrossRefPubMedGoogle Scholar
  18. 18.
    Buffart LM, Kalter J, Sweegers MG et al (2017) Effects and moderators of exercise on quality of life and physical function in patients with cancer: an individual patient data meta-analysis of 34 RCTs. Cancer Treat Rev 52:91–104CrossRefPubMedGoogle Scholar
  19. 19.
    Burke S, Wurz A, Bradshaw A, Saunders S, West MA, Brunet J (2017) Physical activity and quality of life in cancer survivors: a meta-synthesis of qualitative research. Cancers 9(5):E53Google Scholar
  20. 20.
    Cormie P, Zopf E, Zhang X, Schmitz K (2017) The impact of exercise on cancer mortality, recurrence, and treatment-related adverse effects. Epidemiol Rev 39:71–92CrossRefPubMedGoogle Scholar
  21. 21.
    Knox ECL, Esliger DW, Biddle SJH, Sherar LB (2013) Lack of knowledge of physical activity guidelines: can physical activity promotion campaigns do better? BMJ Open 3:e003633CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    Chatterjee R, Chapman T, Brannan MG, Varney J (2017) GPs’ knowledge, use, and confidence in national physical activity and health guidelines and tools: a questionnaire-based survey of general practice in England. Br J Gen Pract 67:e668–e675CrossRefPubMedGoogle Scholar
  23. 23.
    Snyder LB (2007) Health communication campaigns and their impact on behavior. J Nutr Educ Behav 39:S32–S40CrossRefPubMedGoogle Scholar
  24. 24.
    Weinstein ND (1988) The precaution adoption process. Health Psychol 7:355–386CrossRefPubMedGoogle Scholar
  25. 25.
    Macmillan move more: physical activity the underrated ‘wonder drug’. 2011. https://www.macmillan.org.uk/documents/aboutus/newsroom/physicalactivityreport.pdf. Accessed 02 Mar 2018
  26. 26.
    O’Leary KA, Estabrooks CA, Olson K, Cumming C (2007) Information acquisition for women facing surgical treatment for breast cancer: influencing factors and selected outcomes. Patient Educ Couns 69:5–19CrossRefPubMedGoogle Scholar
  27. 27.
    Jones LW, Courneya KS (2002) Exercise discussions during cancer treatment consultations. Cancer Pract 10:66–74CrossRefPubMedGoogle Scholar
  28. 28.
    Cantwell M, Walsh D, Furlong B et al (2018) Healthcare professionals’ knowledge and practice of physical activity promotion in cancer care: challenges and solution. Eur J Cancer Care 27(2):e12795Google Scholar
  29. 29.
    Keogh JWL, Olsen A, Climstein M, Sargeant S, Jones L (2017) Benefits and barriers of cancer practitioners discussing physical activity with their cancer patients. J Cancer Educ 32(1):11–15CrossRefPubMedGoogle Scholar
  30. 30.
    Queen M, Karatzaferi C, Bloxham SR et al (2016) How can physical activity referral rates for breast cancer patients be increased? Front Oncol 12(6):198Google Scholar
  31. 31.
    The Health and Social Care Information Centre (2009) Health survey for England 2008: physical activity and fitness. NHS - Health and Social Care Information Centre, LondonGoogle Scholar
  32. 32.
    Blanchard CM, Denniston MM, Baker F, Ainsworth SR, Courneya KS, Hann DM, Gesme DH, Reding D, Flynn T, Kennedy JS (2003) Do adults change their lifestyle behaviors after a cancer diagnosis? Am J Health Behav 27:246–256CrossRefPubMedGoogle Scholar
  33. 33.
    Fernandez S, Franklin J, Amlani N, DeMilleVille C, Lawson D, Smith J (2015) Physical activity and cancer: a cross-sectional study on the barriers and facilitators to exercise during cancer treatment. Can Oncol Nurs J 25:37–48CrossRefPubMedGoogle Scholar
  34. 34.
    Tarasenko Y, Chen C, Schoenberg N (2017) Self-reported physical activity levels of older cancer survivors: results from the 2014 national health interview survey. J Am Geriatr Soc 65:e39–e44CrossRefPubMedGoogle Scholar
  35. 35.
    Grimmett C, Wardle J, Steptoe A (2009) Health behaviours in older cancer survivors in the English longitudinal study of ageing. Eur J Cancer 45:2180–2186CrossRefPubMedGoogle Scholar
  36. 36.
    Gjerset GM, Fossa SD, Courneya KS, Skovlund E, Thorsen L (2011) Exercise behaviour in cancer survivors and associated factors. J Cancer Surviv 5:35–43CrossRefPubMedGoogle Scholar
  37. 37.
    Yang D, Hausien O, Aqeel M, Klonis A, Foster J, Renshaw D, Thomas R (2017) Physical activity levels and barriers to exercise referral among patients with cancer. Patient Educ Couns 100(7):1402–1407CrossRefPubMedGoogle Scholar
  38. 38.
    Blaney JM, Lowe-Strong A, Rankin-Watt J, Campbell A, Gracey JH (2013) Cancer survivors’ exercise barriers, facilitators and preferences in the context of fatigue, quality of life and physical activity participation: a questionnaire–survey. Psycho Oncol 22:186–194CrossRefGoogle Scholar
  39. 39.
    Leach C, Bellizzi K, Hurria A, Reeve B (2016) Is it my cancer or am I just getting older?: impact of cancer on age-related health conditions of older cancer survivors. Cancer 122:1946–1953CrossRefPubMedGoogle Scholar
  40. 40.
    Midtgaard J, Hammer N, Andersen C, Larsen A, Bruun D, Jarden M (2015) Cancer survivors’ experience of exercise-based cancer rehabilitation - a meta-synthesis of qualitative research. Acta Oncol 54:609–617CrossRefPubMedGoogle Scholar
  41. 41.
    Baumann FT, Zopf EM, Bloch W (2012) Clinical exercise interventions in prostate cancer patients- a systematic review of randomized controlled trials. Support Care Cancer 20:221–233CrossRefPubMedGoogle Scholar
  42. 42.
    Moreton R, Stutz R, Robinson S, Mulla M, Winter M, Roberts J, Hillsdon M (2017) Evaluation of the Macmillan physical activity behaviour change care pathway. Final report 2017. Leicester, CFE ResearchGoogle Scholar
  43. 43.
    Swartz MC, Lewis ZH, Lyons EJ, Jennings K, Middleton A, Deer RR, Arnold D, Dresser K, Ottenbacher KJ, Goodwin JS (2017) Effect of home- and community-based physical activity interventions on physical function among cancer survivors: a systematic review and meta-analysis. Arch Phys Med Rehabil 98:1652–1665CrossRefPubMedGoogle Scholar
  44. 44.
    Philips SM, Conroy DE, Keadle SK, Pellegrini CA, Lloyd GR, Penedo FJ, Spring B (2017) Breast cancer survivors’ preferences for technology-supported exercise interventions. Support Care Cancer 25:3243–3252CrossRefGoogle Scholar
  45. 45.
    Puszkiewicz P, Roberts A, Smith L, Wardle J, Fisher A (2016) Assessment of cancer survivors’ experiences of using a publicly available physical activity mobile application. JMIR Cancer 2:e7.  https://doi.org/10.2196/cancer.5380 CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Sussex Health Outcomes Research and Education in Cancer (SHORE-C), Brighton and Sussex Medical SchoolUniversity of SussexBrightonUK
  2. 2.Cancer United™ (charity No. 1155747)West SussexUK

Personalised recommendations