Skip to main content
Top
Published in: Supportive Care in Cancer 7/2017

01-07-2017 | Original Article

Oncology care provider perspectives on exercise promotion in people with cancer: an examination of knowledge, practices, barriers, and facilitators

Authors: Michelle Nadler, Daryl Bainbridge, Jennifer Tomasone, Oren Cheifetz, Rosalyn A. Juergens, Jonathan Sussman

Published in: Supportive Care in Cancer | Issue 7/2017

Login to get access

Abstract

Background

Despite the reported benefits of physical activity in alleviating the impact of cancer and its treatments, oncology care providers (OCPs) are not routinely discussing exercise with their patients, suggesting a knowledge to action gap. We sought to determine OCP’s knowledge, beliefs, barriers, and facilitators to exercise discussion.

Methods

A survey was administered to OCPs at the cancer center in Hamilton, Ontario. Questions comprised of demographics, knowledge and beliefs regarding exercise guidelines, and barriers and facilitators to exercise discussion. Analysis of survey responses was descriptive. Pearson’s chi-squared test was used to examine select associations.

Results

There were 120 respondents (61% response rate) representing a diversity of professions. Approximately, 80% of OCPs were not aware of any exercise guidelines in cancer and self-reported poor knowledge on when, how, and which patients to refer to exercise programs. OCPs who reported meeting Canada’s Physical Activity guidelines were significantly more likely to identify correct guidelines (p = 0.023) and to report good knowledge on how to provide exercise counseling (p = 0.014). Across OCP groups, barriers to exercise discussion included poor knowledge, lack of time, and safety concerns. Most felt that educational sessions and having an exercise specialist on the clinical team would be beneficial.

Conclusions

OCPs have low knowledge regarding exercise counseling, but believe that discussing exercise is a multidisciplinary task and expressed a desire for further training. Interventions will require a multi-pronged approach including education for OCPs and guidance on assessment for exercise safety.
Literature
3.
go back to reference Ewertz M, Jensen AB (2011) Late effects of breast cancer treatment and potentials for rehabilitation. Acta Oncol 50(2):187–193CrossRefPubMed Ewertz M, Jensen AB (2011) Late effects of breast cancer treatment and potentials for rehabilitation. Acta Oncol 50(2):187–193CrossRefPubMed
4.
go back to reference Shao YH et al (2013) Fracture after androgen deprivation therapy among men with a high baseline risk of skeletal complications. BJU Int 111(5):745–752CrossRefPubMedPubMedCentral Shao YH et al (2013) Fracture after androgen deprivation therapy among men with a high baseline risk of skeletal complications. BJU Int 111(5):745–752CrossRefPubMedPubMedCentral
5.
go back to reference Harrington CB et al (2010) It's not over when it's over: long-term symptoms in cancer survivors—a systematic review. Int J Psychiatry Med 40(2):163–181CrossRefPubMed Harrington CB et al (2010) It's not over when it's over: long-term symptoms in cancer survivors—a systematic review. Int J Psychiatry Med 40(2):163–181CrossRefPubMed
6.
go back to reference Schmitz KH et al (2010) American College of Sports Medicine roundtable on exercise guidelines for cancer survivors. Med Sci Sports Exerc 42(7):1409–1426CrossRefPubMed Schmitz KH et al (2010) American College of Sports Medicine roundtable on exercise guidelines for cancer survivors. Med Sci Sports Exerc 42(7):1409–1426CrossRefPubMed
7.
go back to reference Stene GB et al (2013) Effect of physical exercise on muscle mass and strength in cancer patients during treatment—a systematic review. Crit Rev Oncol Hematol 88(3):573–593CrossRefPubMed Stene GB et al (2013) Effect of physical exercise on muscle mass and strength in cancer patients during treatment—a systematic review. Crit Rev Oncol Hematol 88(3):573–593CrossRefPubMed
8.
go back to reference Speed-Andrews AE, Courneya KS (2009) Effects of exercise on quality of life and prognosis in cancer survivors. Curr Sports Med Rep 8(4):176–181CrossRefPubMed Speed-Andrews AE, Courneya KS (2009) Effects of exercise on quality of life and prognosis in cancer survivors. Curr Sports Med Rep 8(4):176–181CrossRefPubMed
9.
go back to reference Irwin ML et al (2011) Physical activity and survival in postmenopausal women with breast cancer: results from the women's health initiative. Cancer Prev Res (Phila) 4(4):522–529CrossRef Irwin ML et al (2011) Physical activity and survival in postmenopausal women with breast cancer: results from the women's health initiative. Cancer Prev Res (Phila) 4(4):522–529CrossRef
10.
go back to reference Ballard-Barbash R et al (2012) Physical activity, biomarkers, and disease outcomes in cancer survivors: a systematic review. J Natl Cancer Inst 104(11):815–840CrossRefPubMedPubMedCentral Ballard-Barbash R et al (2012) Physical activity, biomarkers, and disease outcomes in cancer survivors: a systematic review. J Natl Cancer Inst 104(11):815–840CrossRefPubMedPubMedCentral
11.
go back to reference Courneya KS et al (2016) Effects of a structured exercise program on physical activity and fitness in colon cancer survivors: one year feasibility results from the CHALLENGE trial. Cancer Epidemiol Biomark Prev 25(6):969–977CrossRef Courneya KS et al (2016) Effects of a structured exercise program on physical activity and fitness in colon cancer survivors: one year feasibility results from the CHALLENGE trial. Cancer Epidemiol Biomark Prev 25(6):969–977CrossRef
12.
go back to reference Segal R, Zwaal C, Green E, Tomasone J, Loblaw A, Petrella T (2015) A quality initiative of the Program in Evidence-Based Care (PEBC), Cancer Care Ontario (CCO) Exercise for People with Cancer Segal R, Zwaal C, Green E, Tomasone J, Loblaw A, Petrella T (2015) A quality initiative of the Program in Evidence-Based Care (PEBC), Cancer Care Ontario (CCO) Exercise for People with Cancer
13.
go back to reference Blaney JM et al (2013) Cancer survivors' exercise barriers, facilitators and preferences in the context of fatigue, quality of life and physical activity participation: a questionnaire-survey. Psychooncology 22(1):186–194CrossRefPubMed Blaney JM et al (2013) Cancer survivors' exercise barriers, facilitators and preferences in the context of fatigue, quality of life and physical activity participation: a questionnaire-survey. Psychooncology 22(1):186–194CrossRefPubMed
14.
go back to reference Peeters C et al (2009) Evaluation of a cancer exercise program: patient and physician beliefs. Psychooncology 18(8):898–902CrossRefPubMed Peeters C et al (2009) Evaluation of a cancer exercise program: patient and physician beliefs. Psychooncology 18(8):898–902CrossRefPubMed
15.
go back to reference Park JH et al (2015) Characteristics of attitude and recommendation of oncologists toward exercise in South Korea: a cross sectional survey study. BMC Cancer 15:249CrossRefPubMedPubMedCentral Park JH et al (2015) Characteristics of attitude and recommendation of oncologists toward exercise in South Korea: a cross sectional survey study. BMC Cancer 15:249CrossRefPubMedPubMedCentral
16.
go back to reference Cheville AL et al (2012) Insights into the reluctance of patients with late-stage cancer to adopt exercise as a means to reduce their symptoms and improve their function. J Pain Symptom Manag 44(1):84–94CrossRef Cheville AL et al (2012) Insights into the reluctance of patients with late-stage cancer to adopt exercise as a means to reduce their symptoms and improve their function. J Pain Symptom Manag 44(1):84–94CrossRef
17.
go back to reference Anderson AS, Steele R, Coyle J (2013) Lifestyle issues for colorectal cancer survivors—perceived needs, beliefs and opportunities. Support Care Cancer 21(1):35–42CrossRefPubMed Anderson AS, Steele R, Coyle J (2013) Lifestyle issues for colorectal cancer survivors—perceived needs, beliefs and opportunities. Support Care Cancer 21(1):35–42CrossRefPubMed
18.
go back to reference Graham ID et al (2006) Lost in knowledge translation: time for a map? J Contin Educ Heal Prof 26(1):13–24CrossRef Graham ID et al (2006) Lost in knowledge translation: time for a map? J Contin Educ Heal Prof 26(1):13–24CrossRef
20.
go back to reference Park JH et al (2015) The effect of oncologists' exercise recommendations on the level of exercise and quality of life in survivors of breast and colorectal cancer: a randomized controlled trial. Cancer 121(16):2740–2748CrossRefPubMedPubMedCentral Park JH et al (2015) The effect of oncologists' exercise recommendations on the level of exercise and quality of life in survivors of breast and colorectal cancer: a randomized controlled trial. Cancer 121(16):2740–2748CrossRefPubMedPubMedCentral
21.
go back to reference Cheifetz O (2007) Cancer and exercise: a survey of patients' knowledge and preferences. Hamilton, Ontario Cheifetz O (2007) Cancer and exercise: a survey of patients' knowledge and preferences. Hamilton, Ontario
22.
go back to reference Godin G, Shephard RJ (1985) A simple method to assess exercise behavior in the community. Can J Appl Sport Sci 10(3):141–146PubMed Godin G, Shephard RJ (1985) A simple method to assess exercise behavior in the community. Can J Appl Sport Sci 10(3):141–146PubMed
23.
go back to reference MacCallum RC et al (2002) On the practice of dichotomization of quantitative variables. Psychol Methods 7(1):19–40CrossRefPubMed MacCallum RC et al (2002) On the practice of dichotomization of quantitative variables. Psychol Methods 7(1):19–40CrossRefPubMed
25.
go back to reference Davis DA et al (1995) Changing physician performance. A systematic review of the effect of continuing medical education strategies. JAMA 274(9):700–705CrossRefPubMed Davis DA et al (1995) Changing physician performance. A systematic review of the effect of continuing medical education strategies. JAMA 274(9):700–705CrossRefPubMed
26.
go back to reference Fisher A et al (2015) Recall of physical activity advice was associated with higher levels of physical activity in colorectal cancer patients. BMJ Open 5(4):e006853CrossRefPubMedPubMedCentral Fisher A et al (2015) Recall of physical activity advice was associated with higher levels of physical activity in colorectal cancer patients. BMJ Open 5(4):e006853CrossRefPubMedPubMedCentral
27.
go back to reference Jones LW et al (2004) Effects of an oncologist's recommendation to exercise on self-reported exercise behavior in newly diagnosed breast cancer survivors: a single-blind, randomized controlled trial. Ann Behav Med 28(2):105–113CrossRefPubMed Jones LW et al (2004) Effects of an oncologist's recommendation to exercise on self-reported exercise behavior in newly diagnosed breast cancer survivors: a single-blind, randomized controlled trial. Ann Behav Med 28(2):105–113CrossRefPubMed
28.
go back to reference McGowan K (2016) Physical exercise and cancer-related fatigue in hospitalized patients: role of the clinical nurse leader in implementation of interventions. Clin J Oncol Nurs 20(1):E20–E27CrossRefPubMed McGowan K (2016) Physical exercise and cancer-related fatigue in hospitalized patients: role of the clinical nurse leader in implementation of interventions. Clin J Oncol Nurs 20(1):E20–E27CrossRefPubMed
29.
go back to reference Frank E et al (2010) Predictors of Canadian physicians' prevention counseling practices. Can J Public Health 101(5):390–395 Frank E et al (2010) Predictors of Canadian physicians' prevention counseling practices. Can J Public Health 101(5):390–395
30.
go back to reference Abramson S et al (2000) Personal exercise habits and counseling practices of primary care physicians: a national survey. Clin J Sport Med 10(1):40–48CrossRefPubMed Abramson S et al (2000) Personal exercise habits and counseling practices of primary care physicians: a national survey. Clin J Sport Med 10(1):40–48CrossRefPubMed
31.
go back to reference Duijts SF et al (2011) Effectiveness of behavioral techniques and physical exercise on psychosocial functioning and health-related quality of life in breast cancer patients and survivors—a meta-analysis. Psychooncology 20(2):115–126CrossRefPubMed Duijts SF et al (2011) Effectiveness of behavioral techniques and physical exercise on psychosocial functioning and health-related quality of life in breast cancer patients and survivors—a meta-analysis. Psychooncology 20(2):115–126CrossRefPubMed
32.
go back to reference Midtgaard J et al (2013) Efficacy of multimodal exercise-based rehabilitation on physical activity, cardiorespiratory fitness, and patient-reported outcomes in cancer survivors: a randomized, controlled trial. Ann Oncol 24(9):2267–2273CrossRefPubMedPubMedCentral Midtgaard J et al (2013) Efficacy of multimodal exercise-based rehabilitation on physical activity, cardiorespiratory fitness, and patient-reported outcomes in cancer survivors: a randomized, controlled trial. Ann Oncol 24(9):2267–2273CrossRefPubMedPubMedCentral
33.
go back to reference J., H., Supportive Treatment for Cancer - Part 1: Exercise Treatment. 2012, Health Care Knowledge Centre: Brussels: Belgian. J., H., Supportive Treatment for Cancer - Part 1: Exercise Treatment. 2012, Health Care Knowledge Centre: Brussels: Belgian.
34.
go back to reference Cormie P et al (2013) Safety and efficacy of resistance exercise in prostate cancer patients with bone metastases. Prostate Cancer Prostatic Dis 16(4):328–335CrossRefPubMed Cormie P et al (2013) Safety and efficacy of resistance exercise in prostate cancer patients with bone metastases. Prostate Cancer Prostatic Dis 16(4):328–335CrossRefPubMed
35.
go back to reference Cormie P et al (2014) Functional benefits are sustained after a program of supervised resistance exercise in cancer patients with bone metastases: longitudinal results of a pilot study. Support Care Cancer 22(6):1537–1548CrossRefPubMed Cormie P et al (2014) Functional benefits are sustained after a program of supervised resistance exercise in cancer patients with bone metastases: longitudinal results of a pilot study. Support Care Cancer 22(6):1537–1548CrossRefPubMed
36.
go back to reference Ligibel JA et al (2016) Randomized trial of a physical activity intervention in women with metastatic breast cancer. Cancer 122(8):1169–1177CrossRefPubMed Ligibel JA et al (2016) Randomized trial of a physical activity intervention in women with metastatic breast cancer. Cancer 122(8):1169–1177CrossRefPubMed
Metadata
Title
Oncology care provider perspectives on exercise promotion in people with cancer: an examination of knowledge, practices, barriers, and facilitators
Authors
Michelle Nadler
Daryl Bainbridge
Jennifer Tomasone
Oren Cheifetz
Rosalyn A. Juergens
Jonathan Sussman
Publication date
01-07-2017
Publisher
Springer Berlin Heidelberg
Published in
Supportive Care in Cancer / Issue 7/2017
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-017-3640-9

Other articles of this Issue 7/2017

Supportive Care in Cancer 7/2017 Go to the issue
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine