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“It gave me a sense of achievement and a sense of purpose”—a qualitative study of patient experiences of a virtually supervised exercise program for adults with advanced cancer and cachexia

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Abstract

People with advanced cancer and cachexia experience significant body weight loss, adversely impacting physical function and quality of life (QOL). Effective, evidence-based treatments for cancer cachexia are lacking, leaving patients with unmet needs. Exercise holds promise to improve patient QOL. However, information on patients’ experiences of exercise, including their ability to cope with structured exercise, is limited.

Purpose

To explore patient experiences completing a structured, supervised exercise program for people with cachexia due to advanced cancer.

Methods

Semi-structured interviews were conducted with participants enrolled in a phase II feasibility, randomized controlled trial to explore their experiences of an 8-week virtually supervised exercise program delivered via videoconference technology. Interviews were analysed using reflexive thematic analysis.

Results

Seventeen participants completed interviews (female n = 9, 53%). Main interview themes included the following: (1) Deciding to exercise involves balancing concerns and expectations, (2) the exercise program is a positive experience, and (3) moving forward after the exercise program. While some participants initially held doubts about their physical capabilities and exercise safety, most wanted to exercise to enhance their wellbeing. Participants described the exercise program as a positive experience, offering diverse benefits. Some would have preferred in-person exercise, but all agreed the virtual format increased convenience. Participants emphasized the need to recommend the program to others in similar circumstances. They underscored the necessity and desire for ongoing support to sustain their new exercise habits.

Conclusion

Based on patient experiences, virtually supervised exercise programming appears to be feasible and meaningful to people with advanced cancer and cachexia.

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Data availability

No datasets were generated or analysed during the current study.

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Funding

Funding to support this research was provided by the Cabrini Foundation.

Author information

Authors and Affiliations

  1. Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada

    Kelcey A. Bland

  2. Cancer Control, BC Cancer Research Institute, Vancouver, BC, Canada

    Kelcey A. Bland

  3. Department of Medical Oncology, Cabrini Health, Malvern, VIC, Australia

    Madeleine France-Ratcliffe & Eva M. Zopf

  4. Department of Nursing, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, VIC, Australia

    Meinir Krishnasamy & Amruta Nandi

  5. Victorian Comprehensive Cancer Centre Alliance, Melbourne, VIC, Australia

    Meinir Krishnasamy

  6. Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia

    Amruta Nandi & Prue Cormie

  7. Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia

    Evelyn B. Parr, Luc J. C. van Loon & Eva M. Zopf

  8. School of Medicine, Deakin University, Geelong, VIC, Australia

    Peter Martin

  9. Palliative Care, Barwon Health, Geelong, VIC, Australia

    Peter Martin

  10. Department of Human Biology, NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, Netherlands

    Luc J. C. van Loon

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  1. Kelcey A. Bland
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Contributions

K.A.B., M.K., E.P., L.J.C.vL, P.C., P.M., and E.M.Z. contributed to the study conception and design. Material preparation, data collection, and analysis were performed by K.A.B., M.F.R., and A.N. The first draft of the manuscript was written by K.A.B. and M.F.R., and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Kelcey A. Bland.

Ethics declarations

Ethics approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Human Research Ethics Committee (HREC) of St. Vincent’s Hospital Melbourne, Australia (HREC 251/18).

Consent to participate

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

Consent for publication

All individual participants consented to the publication of their de-identified data.

Competing interests

L.J.C.vL has received research grants, consulting fees, speaking honoraria, or a combination of these, from Kenniscentrum Suiker & Voeding and PepsiCo.

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Bland, K.A., France-Ratcliffe, M., Krishnasamy, M. et al. “It gave me a sense of achievement and a sense of purpose”—a qualitative study of patient experiences of a virtually supervised exercise program for adults with advanced cancer and cachexia. Support Care Cancer 32, 325 (2024). https://doi.org/10.1007/s00520-024-08526-y

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