Open Access Open Access  Restricted Access Subscription Access

The impact of physical activity for recovering cancer patients

Martyn Queen, Diane Crone, Andrew Parker, Saul Bloxham

Abstract


Rationale: There is a growing body of evidence that supports the use of physical activity during and after cancer treatment, although activity levels for patients remain low. As more cancer patients are treated successfully and treatment costs continue to escalate, physical activity may be a promising adjunct to a person-centered healthcare approach to recovery.

Aim: The aim was to further understand how physical activity may enhance the recovery process for a group of mixed-site cancer patients.

Objectives: The research investigated longitudinal changes in physical activity and perceived quality of life between 2 and 6 month’s post-exercise interventions. It also investigated support systems that enabled patients to sustain these perceived changes.

Method: The respondent cohort comprised 14 mixed-site cancer patients aged 43-70 (11 women, 3 men), who participated in a 2-phase physical activity intervention that took place at a university in the South West of England, UK. Phase 1 consisted of an 8 week structured physical activity programme; Phase 2 consisted of 4 months of non-supervised physical activity. Semi-structured interviews took place 3 times over 6 months with each participant. Grounded theory informed the data collection and analysis which, in turn, facilitated theoretical development.

Findings: Our findings propose 3 theories on the impact of physical activity for recovering cancer patients: (1) Knowledge gained through a structured exercise programme can enable recovering cancer patients to independently sustain physical activity to 4 month follow-up. (2) Sustaining physical activity for 6 months promotes positive changes in the quality of life indicators of chronic fatigue, self-efficacy, ability to self-manage and energy levels & (3) Peer support from patients facilitates adherence to a structured exercise programme and support from a spouse or life partner facilitates independently sustained physical activity to 4 month follow-up.

Conclusions: This study demonstrates that qualitative research can provide an evidence base that could be used to support future care plans for cancer patients. Our findings also demonstrate that a physical activity intervention can be effective at helping cancer patients recover from the side effects of their treatment and we recommend that physical activity should become an adjunct therapy alongside traditional cancer treatments.


Keywords


Cancer recovery, grounded theory, health, person-centered healthcare, physical activity, qualitative research, quality of life, support systems,

Full Text:

PDF

References


Campbell, A., Stevinson, C. & Crank, H. (2012). The BASES Expert Statement on exercise and cancer survivorship. Journal of Sports Science 30 (9) 949-952.

Craft, L.L., Vaniterson, E.H., Helenowski, I.B., Rademaker, A.W. & Courneya, K.S. (2012). Exercise effects on depressive symptoms in cancer survivors: a systematic review and meta-analysis. Cancer Epidemiological Biomarkers and Prevention 21, 3-19.

McNeely, M.L., Campbell, K.L., Rowe, B.H., Klassen, T.P., Mackey, J. R. & Courneya, K.S. (2006). Effects of exercise on breast cancer patients and survivors: a systematic review and meta-analysis. Canadian Medical Association Journal 175, 34-41.

Carmichael, A.R., Daley, A.J., Rea, D.W. & Bowden, S.J. (2010). Physical activity and breast cancer outcome: A brief review of evidence, current practice and future direction. European Journal of Surgical Oncology 36 (12) 1139-1148.

Queen, M., Bloxham, S., Brown, P., Coyle, M. & Jane, B. (2016). Perceived changes to quality of life indicators following a physical activity intervention for recovering cancer patients: A qualitative study. European Journal for Person Centered Healthcare 4 (2) 305-315.

Sabiston, C.M. & Brunet, J. (2011). Reviewing the benefits of physical activity during cancer survivorship. American Journal of Lifestyle Behaviour 6, 167-177.

Queen, M., Bloxham, S., Brown, P., Coyle, M. & Jane, B. (2016). Impact of an exercise programme on sustaining physical activity for recovering cancer patients: A qualitative study. European Journal for Person Centered Healthcare 4 (1) 230-240.

Queen, M., Bloxham, S. & Brown, P. (2016). Support systems for mixed-site recovering cancer patients to sustain physical activity: a qualitative study. European Journal for Person Centered Healthcare 5 (1) 102-110.

Maddams, J., Brewster, D., Gavin, A., Steward, J., Elliott, J., Utley, M. & Moller, H. (2009). Cancer prevalence in the United Kingdom: estimates for 2008. British Journal of Cancer 101, 541-547.

Blanchard, C.M., Courneya, K.S. & Stein, K. (2008). Cancer survivors’ adherence to lifestyle behaviour recommendations and associations with health-related QoL: results from the American Cancer Society’s SCS-II. Journal of Clinical Oncology 26, 2198-2204.

Courneya, K.S., Katzmarzyk, P.T. & Bacon, E. (2008). Physical activity and obesity in Canadian cancer survivors: population-based estimates from the 2005 Canadian Community Health Survey. Cancer 112, 2475-2482.

De Backer, I.C., Schep, G., Backx, F.J., Vreugdenhil, G. & Kuipers, H. (2009). Resistance training in cancer survivors: A systematic review. International Journal of Sports Medicine 30, 703-712.

Midtgaard, J., Christensen, J. F., Tolver, A., Jones, L.W., Uth, J., Rasmussen, B. & Rørth, M. (2013). Efficacy of multimodal exercise-based rehabilitation on physical activity, cardiorespiratory fitness, and patient-reported outcomes in cancer survivors: A randomized, controlled trial. Annals of Oncology 24, 2267-2273.

Courneya, K., Segal, R., Gelmon, K., Mackey, J., Friedenreich, C., Yasui , Y., Reid, R., Proulx, C., Trinh, L. & Dolan, L., Wooding, E., Vallerand, J.R. & McKenzie, D.C. (2014). Predictors of adherence to different types and doses of supervised exercise during breast cancer chemotherapy. International Journal of Behavioral Nutrition and Physical Activity 11 (85) 1-19.

American Cancer Society (2016). Current grants by cancer type. Available at:

http://www.cancer.org/research/currentlyfundedcancerresearch/grants-by-cancer-type. (Accessed 1/12/16).

McCorkle, R., Ercolano, E., Lazenby, M., Schulman‐Green, D., Schilling, L.S., Lorig, K. & Wagner, E.H. (2011). Self‐management: Enabling and empowering patients living with cancer as a chronic illness. CA: A Cancer Journal for Clinicians 61 (1) 50-62.

Rao, A.V. & Demark-Wahnefried, W. (2006). The older cancer survivor. Critical Reviews in Oncology/Hematology 60 (2) 131-143.

Barlow, J., Wright, C., Sheasby, J., Turner, A. & Hainsworth, J. (2002). Self-management approaches for people with chronic conditions: a review. Patient Education and Counseling 48 (2) 177-187.

Estabrooks, P.A., Harden, S.M., Johnson, S.B. & Pardo, K.A. (2014). Group integration interventions in exercise. In: Group Dynamics in Exercise and Sport Psychology. Beauchamp, M.R. & Eys, M.A. (Eds.). London: Routledge.

Macmillan Cancer Support. (2012). Interventions to promote physical activity for people living with and beyond cancer: Evidence-based guidance, (March), 1-20.

Havrilesky, L.J., Pokrzywinski, R, Revicki, D, Higgins. R.V, Nycum, L.R, Kohler, M.F, Berchuck, A, Myers, E.R. & Secord, A.A. (2012). Cost-effectiveness of combination versus sequential docetaxel and carboplatin for the treatment of platinum-sensitive, recurrent ovarian cancer. Cancer 118 (2) 386-391.

Dilla, T., Lizan, L., Paz, S., Garrido, P., Avendaño, C., Cruz-Hernández, J., Espinosa, J. & Sacristán, J. (2016). Do new cancer drugs offer good value for money? The perspectives of oncologists, health care policy makers, patients, and the general population. Patient Preference and Adherence 10, 1-7.

NICE. (2006). National Institute for Health and Care Excellence. Modelling the cost effectiveness of physical activity interventions. Matrix research and consultancy.

Miles, A. & Asbridge, J.E. (2016). The chronic illness problem. The person-centered solution. European Journal for Person Centered Healthcare 4 (1) 1-5.

Dahlgren, G. & Whitehead, M. (1991). Policies and strategies to promote social equity in health: Background document to WHO- strategy paper for Europe. Stockholm: Institute for Future Studies.

Queen, M., Crone, D. & Parker, A. (2015). Long-term engagement with a practice-based exercise referral scheme: Patients’ Perceptions of Effectiveness. European Journal for Person Centered Healthcare 3 (3) 369-376.

Strauss, A.L. & Corbin, J. (1998). Basics of Qualitative Research. Techniques and Procedures for Developing Grounded Theory (2nd edn). California: Sage.

Bryman, A. (2012). Social Research Methods (4th edn). Oxford: Oxford University Press.

Kelle, U. (2005). Emergence vs. ‘Forcing’ of Empirical Data? A Crucial Problem of ‘Grounded Theory’ Reconsidered. Forum. Qualitative Social Research 6 (2) 27.

Hutchinson, A.J., Johnston, L. & Breckon, J. (2011). Grounded Theory Based Research with Exercise Psychology: A Critical Review. Qualitative Research in Psychology 8, 247-272.

Lincoln, Y.S. & Guba, E.G. (1985). Naturalistic Enquiry. California: Sage.

Sparkes, A.C. & Smith, B. (2014). Qualitative Research Methods in Sport Exercise and Health: From process to product. Abingdon, Oxon: Routledge.

Tracey, S. (2010). Qualitative quality: Eight ‘big tent’ criteria for excellent qualitative research. Qualitative Enquiry 16, 837-851.

Knols, R.H., de Bruin, E.D., Shirato, K., Uebelhart, D. & Aaronson, N.K. (2010). Physical activity interventions to improve daily walking activity in cancer survivors. BMC Cancer 10, 406.

Sander, A.P., Wilson, J., Izzo, N., Mountford, S.A. & Hayes, K.W. (2012). Factors That Affect Decisions About Physical Activity and Exercise in Survivors of Breast Cancer: A Qualitative Study. Physical Therapy 92 (4) 525-536.

Keogh, J.W.L., Patel, A., Macleod, R.D. & Masters, J. (2014). Perceived barriers and facilitators to physical activity in men with prostate cancer: Possible influence of androgen deprivation therapy. European Journal of Cancer Care 23, 263-273.

Vallance, J.K., Culos-Reed, S.N., Mackenzie, M. & Courneya, K.S. (2012). Physical Activity and Psychosocial Health among Cancer Survivors. In: Routledge Handbook of Physical Activity and Mental Health, Ekkekakis, P., (Ed.). pp. 518-529. Abingdon, Oxon: Routledge.

Naumann, F., Munro, A., Martin, E., Magrani, P., Buchan, J., Smith, C. & Philpott, M. (2012). An individual‐based versus group‐based exercise and counselling intervention for improving quality of life in breast cancer survivors. A feasibility and efficacy study. Psycho‐Oncology 21 (10) 1136-1139.

Pinto, B.M., Frierson, G.M., Rabin, C., Trunzo, J.J. & Marcus, B.H. (2005). Home-Based Physical Activity Intervention for Breast Cancer Patients. Journal of Clinical Oncology 23 (15) 3577-3587.

Blacklock, R., Rhodes, R., Blanchard, C. & Gaul, C. (2010). Effects of exercise intensity and self-efficacy on state anxiety with breast cancer survivors. Oncology Nursing Forum 37 (2) 206-212.

Craft, L.L., Vaniterson, E.H., Helenowski, I.B., Rademaker, A.W. & Courneya, K.S. (2012). Exercise effects on depressive symptoms in cancer survivors: a systematic review and meta-analysis. Cancer Epidemiology Biomarkers Prevention 21, 3-19.

Shapiro, C.L. & Recht, A. (2001). Side effects of adjuvant treatment of breast cancer. New England Journal of Medicine 344 (26) 1997-2008.

Buffart, L.M., Ros, W.J.G., Chinapaw, M.J.M., Brug, J., Knol, D.L., Korstjens, I. & May, A.M. (2014). Mediators of physical exercise for improvement in cancer survivors' quality of life. Psycho‐Oncology 23 (3) 330-338.

Emslie, C., Whyte, F., Campbell, A., Mutrie, N., Lee, L., Ritchie, D. & Kearney, N. (2007). “I wouldn”t have been interested in just sitting round a table talking about cancer’; exploring the experiences of women with breast cancer in a group exercise trial. Health Education Research 22 (6) 827-838.

Pentecost, C. & Taket, A. (2011). Understanding exercise uptake and adherence for people with chronic conditions: a new model demonstrating the importance of exercise identity, benefits of attending and support. Health Education Research 26 (5) 908-922.

Midtgaard, J., Rorth, M., Stelter, R. & Adamsen, L. (2006). The group matters: an explorative study of group cohesion and quality of life in cancer patients participating in physical exercise intervention during treatment. European Journal of Cancer Care 15 (1) 25-33.




DOI: http://dx.doi.org/10.5750/ejpch.v5i2.1295

Refbacks

  • There are currently no refbacks.