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Abstract
Objective To explore physically inactive breast and colon cancer patients’ prediagnosis exercise history and attitudes to physical activity (PA) and experiences in initiating PA while undergoing adjuvant chemotherapy.
Design An explorative qualitative study guided the interpretive analysis of semistructured, open-ended interviews conducted at initiation of chemotherapy and after 12 weeks. The study was embedded in a pilot randomised controlled trial.
Setting Participants were recruited from the Oncological Department at a hospital in Copenhagen, Denmark.
Participants 33 patients with cancer, median age 49 years: 25 patients with breast cancer and 8 with colon cancer, 72% with a low cardiac respiratory fitness level and the majority with a high level of education. Patients received adjuvant chemotherapy, oncologist’s PA recommendation and exercise, cancer nurse specialist’s counselling prior to allocation to PA interventions or waitlist control group.
Results Prediagnosis exercise had been excluded from patients’ daily lives due to perceptions of exercise as boring, lack of discipline and stressful work conditions for both genders. Recommendations from oncologists and nurses inspired the patients to reconsider their attitudes and behaviour by accepting recruitment and participation in PA interventions during chemotherapy. Despite extensive side effects, most patients adhered to their PA commitment due to their perception of the bodily, emotional and social benefits and support of healthcare professionals, peers and family.
Conclusion The patients’ attitude towards exercise transformed from having no priority in patients’ daily lives prediagnosis to being highly prioritised. This study identified four important phases in the exercise transformation process during the patients’ treatment trajectory of relevance to clinicians in identifying, motivating and supporting physically inactive patients with cancer at long-term risk. Clinicians should address young, highly educated patients with cancer at onset of adjuvant chemotherapy due to their specific risk of a sedentary lifestyle resulting from being in stressful, ambitious careers.
Trial registration number Current Controlled Trials (ISRCTN24901641), Stage: Qualitative results.
- chemotherapy
- breast tumours
- gastrointestinal tumours
- qualitative research
- rehabilitation medicine
- sports medicine
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Footnotes
Contributors LA was responsible for data collection; furthermore, LA was first author and together with CA and TM participated in data analysis, interpretation and writing processes. CL and KB had a leading role in the intervention activities. All authors have read and approved the final manuscript.
Funding The present study was conducted by grants from the Center for Integrated Rehabilitation of Cancer patients (CIRE), which was established in 2011 and is supported by the Danish Cancer Society and the Novo Nordisk Foundation. The project has furthermore received grants from TrygFonden Denmark, grant no 7-12-0401.
Competing interests None declared.
Patient consent Detail has been removed from this case description/these case descriptions to ensure anonymity. The editors and reviewers have seen the detailed information available and are satisfied that the information backs up the case the authors are making.
Ethics approval The Scientific Ethics Committee of the Capital Region of Denmark and the Danish Data Protection Agency.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement No additional data are available.