Encouraging Physical Activity After Cancer Requires Oncologist Involvement, Researchers Say

A new commentary suggests that interventions to promote physical activity in survivors of cancer should be delivered at home and guided by oncologists.

Physical activity is particularly important for survivors of cancer, as it can prevent chronic illnesses like cardiovascular disease and potentially lessen the risk of cancer recurrence, but few survivors receive guidance or referrals to exercise programs, according to the commentary in Journal of Clinical Oncology. The authors provide some recommendations for increasing participation in such interventions as part of the post-cancer care plan.

First, they noted that cancer survivors may find it difficult to adopt a sustained lifestyle change that requires them to regularly attend the gym, but many exercise programs for this population are delivered in gym facilities. As such, they recommend that home-based programs may help improve patients’ adherence to the regimen while also costing less than facility-based programs.

The authors also noted the opportunity for oncologists to become more involved in promoting healthy behaviors like physical exercise among patients who have survived cancer. As these patients generally trust their oncologists after having relied on them to treat their cancer, these clinicians are a natural choice to suggest exercise as a way to maintain good health going forward. Oncologist visits represent a logistic opportunity to introduce the idea of physical activity programs, but the oncologists need to be equipped with the resources necessary to guide patients into such programs.

“Future interventions that bypass the oncologist are unlikely to be scalable or to reach many patients; therefore, there is a need to support oncologists in acquiring skills to promote physical activity,” the researchers wrote.

They cited evidence from various studies to support their statement that the gym-based programs currently offered are not in alignment with patients’ desires, as many survivors of cancer would prefer home-based, unsupervised exercise regimens that mostly consist of walking. Research has found these patients are open to the idea of receiving physical activity education and would prefer to hear it from their clinician, but just 19% of oncologists reported providing specific exercise recommendations to at least half of their patients.

Looking forward, the authors recommended some ways to integrate screening for physical activity into the oncology practice workflow. Patients identified as inactive could be provided with educational materials and receive motivational interviewing from their oncology specialists. Practices could also form partnerships with exercise science or physiotherapy departments of universities, whose students could help deliver home-based exercise regimens.

“In summary, we suggest that oncologists are critical to the effective promotion and durable uptake of physical activity among survivors of cancer,” the authors concluded, noting that further research will be needed to ensure the efficacy of exercise promotion interventions.

“The challenge is to identify physical activity interventions that are accessible and sustainable and that can be generalized to a large proportion of survivors of cancer,” they wrote.