No abstract

Physical activity (PA) during and after cancer treatment can help with symptom management and reduce the risk of cancer recurrence. However, it is unclear what constitutes an optimal exercise program. In addition, provider and patient barriers exist to the recommendation and adoption of exercise as part of a cancer treatment plan. The goal of this study was to determine how providers and patients feel about exercise during cancer treatment and explore what the barriers to implementing such a program might be. Focus groups and interviews were held with patients with malignancy, both metastatic and nonmetastatic, and oncology providers. In total, 20 patients participated in either a focus group or an individual interview and 9 providers contributed to the focus group. An equal number of patients (n=10) were interviewed as attended a focus group. Audiotaped sessions were transcribed verbatim. Theme identification was independently coded by 4 coders and synthesized as a group. Neither patient group recalled PA instruction from oncology providers during their cancer treatment. Most participants (95%) felt exercise is important during cancer treatment, citing overall well-being benefits versus improved disease outcome. Most patients (80%) preferred a home-based exercise program provided by the oncologist. Fatigue was the most cited barrier to regular exercise during treatment (50%). All providers acknowledged benefits of PA to patients, but not universally for all. More than half of providers (55%) preferred a referral system for exercise programs. Clinic visit time constraints and a perceived lack of expertise in the area of PA were common barriers to making exercise recommendations a routine part of the treatment plan. Patients with cancer and oncologists recognize the benefits of PA during treatment. Disagreement exists between to whom, how, and where exercise plans should be disseminated and implemented.

Krabbamein í ristli og endaþarmi eru þriðja algengasta tegund krabbameina í hinum vestraena heimi. Algengi þeirra vex með haekkandi aldri. AExlin eru oftast staðbundin í ristli, með eða án meinvarpa í naerlaegum eitlum við greiningu en um 20% sjúklinga greinast með útbreiddan sjúkdóm. Skimun getur dregið úr tíðni krabbameina og laekkað dánartíðni. Flest vestraen lönd maela með ristilspeglun frá 50 ára aldri. Skurðaðgerð er meginaðferðin í meðferð við staðbundnum sjúkdómi en krabbameinslyfja-meðferð eftir aðgerð getur dregið úr endurkomu, sérstaklega ef meinið hefur dreift sér til eitla. Geislameðferð, yfirleitt samhliða lyfjameðferð, er auk skurðaðgerðar ein aðalmeðferðin við endaþarmskrabbameinum og er yfirleitt beitt fyrir skurðaðgerð. Við útbreiddum sjúkdómi er lyfjameðferð kjörmeðferð í flestum tilfellum en stundum má beita skurðaðgerð til brottnáms meinvarpa. umtalsverðar framfarir hafa orðið í meðferð útbreidds sjúkdóms á síðari árum en 6 ný lyf hafa komið fram síðan 1996.