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The experience of outdoor physical activity for skin cancer survivors: understanding the importance of the built and natural environments

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Abstract

Purpose

Cancer patients are encouraged to do more physical activity (PA). Exercising in outdoor settings, however, may expose people to UV radiation, which is the main risk factor of melanoma. This study aimed to understand how melanoma diagnoses affect people’s perception of the outdoor environment for PA.

Method

In-depth interviews were conducted among 19 individuals (20–85 years) with a history of melanoma at a skin cancer clinic in the Denver metropolitan area. Transcribed interviews were coded for emergent themes. The coding framework included topics related to PA behavior, sun protection, and perceptions of outdoor environment.

Results

Respondents reported no change in their level of outdoor activity after the melanoma diagnosis; they tried to reduce the risk of sun exposure by using sunscreen and sun-protective clothing. They also reported seeking shade, trees, and groundcover along urban corridors, in order to avoid sun exposure, reflective surfaces, and heat while being active outdoors.

Conclusion

Given the public health significance of UV exposure and extreme heat, further investments should be made to craft streetscape design guidelines and implement sun-proof spaces across public facilities, including parks, schools, and sport fields in order to ameliorate environmental risks for skin cancer survivors, to prevent future cancers among those that are vulnerable to the hazards of excessive UV exposure and extreme heat, and to promote outdoor PA.

Implications for Cancer Survivors

Skin cancer survivors and other vulnerable population subgroups will benefit from discussions around neighborhood-based design interventions that promote PA while accounting for sun safety.

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Notes

  1. BCC and SCC are also known as keratinocyte carcinomas.

  2. The IOC is an instrument that measures the well-being of cancer survivors in long term and their adaptation to change [59].

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Acknowledgments

We would like to thank all of the individuals who participated in this study. Our work would not be possible without them. In particular, we would like to acknowledge academic and clinical scholars who helped with the completion of this work, including Dr. Brian Muller, Dr. Dave Buller, Dr. Amanda Carrico, and Dr. William Robinson.

Funding

This study was supported by Center to Advance Research and Teaching in Social Sciences (CARTSS) at the University of Colorado Boulder and the Colorado Department of Public Health and Environment (CDPHE). The content of this manuscript is the authors’ sole responsibility and does not necessarily represent the official views of the funding agencies.

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Authors and Affiliations

  1. The Program in Environmental Design, University of Colorado Boulder, Boulder, CO, USA

    S. Tabatabaie

  2. The Environmental Studies Program, University of Colorado Boulder, Boulder, CO, USA

    J. S. Litt

  3. Colorado School of Public Health, Boulder, CO, USA

    L. A. Crane

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  1. S. Tabatabaie
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Correspondence to S. Tabatabaie.

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The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

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The interview procedure was approved by the University of Colorado Boulder’s Institutional Review Board. All procedures performed in this study were in accordance with the ethical standards of the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Selected 26 pictures, their environmental characteristics, and preference measures

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Tabatabaie, S., Litt, J.S. & Crane, L.A. The experience of outdoor physical activity for skin cancer survivors: understanding the importance of the built and natural environments. J Cancer Surviv 14, 739–756 (2020). https://doi.org/10.1007/s11764-020-00889-5

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