Moving forward on all fronts: impact, patterns, and barriers to exercise in cancer survivors and patients living with ad
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ORIGINAL ARTICLE
Moving forward on all fronts: impact, patterns, and barriers to exercise in cancer survivors and patients living with advanced disease Sasha E. Knowlton 1,2,3 & Elizabeth K. O’Donnell 2,3 & Nora Horick 2 & Giselle K. Perez 2,3 & Elyse Park 2 & Julia Rabin 4 & Kit M. Quain 5 & Jessica Garton 2 & Jeffrey M. Peppercorn 2,3 Received: 18 October 2019 / Accepted: 2 February 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Introduction Exercise is recommended for all patients with cancer, but there has been limited study of exercise habits in patients across the spectrum of illness. Purpose This pragmatic survey aimed to identify the unmet supportive care needs, self-reported symptoms, and exercise habits among both cancer survivors and patients living with advanced disease to determine adherence to exercise guidelines and to identify barriers and opportunities to improve exercise. Methods An anonymous cross-sectional self-administered paper survey was distributed to patients with cancer presenting for oncology clinic visits at an academic cancer center. Survey measures included presence of symptoms and health problems in addition to weekly time spent exercising, change in exercise levels since diagnosis, interest in exercise, and self-reported barriers. Participants reporting at least 150 min of exercise per week were characterized as adherent to guidelines. Results Among 640 survey respondents, 570 (89%) completed questions about exercise. Only 44% of cancer survivors and 34% of patients living with advanced disease met current guidelines. Survivors who met exercise guidelines had a lower prevalence of fatigue and memory impairments, but this finding was not seen among patients with advanced cancer. Over 70% of patients with advanced disease and 47% of survivors reported decreasing exercise post-diagnosis compared to pre-diagnosis. Prominent barriers to exercise among both groups included burden of illness and time constraints but interest in increasing exercise was high. Conclusions There is an opportunity to improve exercise and related outcomes among a large percentage of both cancer survivors and patients living with advanced disease. Keywords Exercise; cancer . Symptom burden . Functional status
Introduction Cancer treatment in the form of surgery, radiation, or systemic therapy can adversely impact fitness and functional status,
* Sasha E. Knowlton [email protected] 1
Spaulding Rehabilitation Hospital, Charlestown, MA, USA
2
Massachusetts General Hospital, Boston, MA, USA
3
Harvard Medical School, Boston, MA, USA
4
University of Cincinnati, Cincinnati, OH, USA
5
Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
leading to worsening of quality of life and higher risk of comorbid conditions such as diabetes, cardiac, and pulmonary disease. [1] An emerging body of literature demonstrates that many of the detrimental effects of cancer therapy can be reduced or overcome by exercise among patients with cancer and guidelines ha
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