Barriers and facilitators related to undertaking physical activities among men with prostate cancer: a scoping review

Sattar, Schroder; Haase, Kristen; Bradley, Cara; Papadopoulos, Efthymios; Kuster, S.; Mina, Daniel Santa; Tippe, Mareike; Kaur, Asha; Campbell, Diane; Joshua, Anthony M.; Rediger, C.; Souied, Osama; Alibhai, Shabbir M.H.

doi:10.1038/s41391-021-00399-0

Cited by 20 publications

(19 citation statements)

References 111 publications

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“…Given that clinicians felt they had inadequate knowledge about recommending exercise and looked to others to refer, there is a need for clinician education and formal referral pathways. This conclusion is consistent with a recent scoping review and associated editorial [39,40].…”

Section: Clinician Knowledgesupporting

confidence: 91%

Exercise as a supportive care strategy in men with prostate cancer receiving androgen deprivation therapy at a regional cancer centre: a survey of patients and clinicians

Elbourne

Soo

O׳Reilly

et al. 2021

Support Care Cancer

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Purpose To understand how frequently exercise is discussed and/or prescribed as a supportive care measure and the barriers and facilitators to exercise uptake for men with prostate cancer receiving androgen deprivation therapy (ADT) at a regional cancer centre. Methods An observational, cross-sectional study was conducted at a regional cancer centre in three stages: (1) Retrospective chart review of men with prostate cancer undergoing ADT to identify the frequency of discussion and/or prescription of supportive care measures; (2) prospective patient survey exploring barriers and facilitators to exercise; and (3) prospective clinician survey exploring barriers, facilitators and awareness of exercise guidelines in men with prostate cancer. Results Files of 100 men receiving ADT (mean age 73 years; mean ADT duration =12 months) in the medical oncology ( n = 50) and radiation oncology ( n = 50) clinics were reviewed. Exercise was discussed with 16% of patients and prescribed directly to 5%. Patient survey ( n = 49). 44.2% of patients reported participating in exercise at a high level. Common barriers to exercise participation included fatigue (51.0%), cancer/treatment-related weakness (46.9%) and joint stiffness (44.9%). 36.7% of patients reported interest in a supervised exercise program. Clinician survey ( n = 22). 36.4% identified one or more exercise guidelines, and 40.9% correctly identified national exercise guidelines. Clinicians reported low knowledge of referral pathways to a supervised exercise program (27.3%). Clinicians believe physiotherapists (95.5%) are most suited to exercise prescription and 72.7% stated that exercise counselling should be part of supportive care. Limited time (63.6%) and patient safety (59.1%) were the two most common barriers to discussing exercise with patients. Clinicians reported that only 21.9% of their patients asked about exercise. The most endorsed facilitators to increase exercise uptake were patient handouts (90.9%) and integration of exercise specialists into the clinical team (86.4%). Conclusion Despite a third of patient respondents indicating an interest in a supervised exercise program, only 16% of patients with prostate cancer undergoing ADT at a regional cancer centre engaged in a discussion about exercise with their treating clinicians. Physical limitations and fatigue were the greatest barriers for patients. Clinicians indicated a need for more clinician education and better integration of exercise specialists into clinical care. A tailored, integrated approach is needed to improve the uptake of exercise in men with prostate cancer. Supplementary Information The online version contains supplementary material available at 10.1007/s00520-021-06512-2.

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Section: Clinician Knowledgesupporting

confidence: 91%

Exercise as a supportive care strategy in men with prostate cancer receiving androgen deprivation therapy at a regional cancer centre: a survey of patients and clinicians

Elbourne

Soo

O׳Reilly

et al. 2021

Support Care Cancer

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“…Indeed, PA has been identified as being an important component of cancer survivorship [17,33] and the pandemic has resulted in a decrease in PA of PLWBC [25]. Recognising the importance of PA for prostate [34], breast [25] and other cancers [35], our research confirmed that the adapted CARE programme was an important ingredient in helping PLWBC to keep physically active during the COVID-19 restrictions. Regardless of whether attendees engaged CARE online or outdoors, sessions provided an important opportunity to secure the physical, social [1,19] and mental health benefits of PA [1,19,36,37].…”

Section: Discussionsupporting

confidence: 65%

An Investigation into the Physical Activity Experiences of People Living with and beyond Cancer during the COVID-19 Pandemic

Pringle

Kime

Zwolinsky³

et al. 2022

IJERPH

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This study investigated the physical activity experiences of people living with and beyond cancer (PLWBC) during the COVID-19 pandemic. Participants attended the cancer and rehabilitation exercise (CARE) programme delivered by a football community trust. Staff (n = 2) and participants (n = 9) attended semi-structured interviews investigating the PA participation and experiences of attending/delivering different modes of CARE, including exercise classes delivered outdoors and delivered online. Interviews also investigated participant aspirations for returning to CARE sessions delivered in person indoors. The findings show that the COVID-19 pandemic and government restrictions impacted on PA participation, yet exercise sessions provided via CARE offered participants an important opportunity to arrest their inactivity, keep active and maintain their fitness and functionality. Barriers to participation of CARE online included access to IT infrastructure, internet connectivity and IT skills and comfort using IT. Regarding CARE outdoors, the weather, range of equipment, variety of exercises and the lack of toilets and seats were barriers. In the different CARE modes, the skills of delivery staff who were sensitive to the needs of participants, social support, and the need for participants to maintain good mental and social health were important facilitators for engagement and are considerations for programme delivery. CARE helped PLWBC to keep physically active.

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“…Factors that impact men’s desire to attend PCa support groups include the lack of time, symptoms of PCa and PCa treatments, the desire to not be a burden, social stigma, accessibility issues and the misconception that support groups are for terminal patients with cancer 24–31. Some physicians are hesitant to refer patients to support groups out of fear of their recommended treatment may be undermined by misinformation presented there 31.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Researchers are still exploring the most effective PE protocol for PCa patients and the best way to motivate those men to exercise 8 14 29 32–36. The literature suggests that supervised group PE has the greatest positive impacts on ADT-related symptoms and patient QoL—and is the modality that PCa patients prefer 16 29. However, a recent review noted that none of the research to date on exercise interventions for PCa patients assessed reversibility; that is, none assessed how long the men sustained their exercise programmes well after the research ended 37.…”

Section: Introductionmentioning

confidence: 99%

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Case studies on psychosocial factors that help make exercise programmes for prostate cancer patients self-sustaining

Fox

Wassersug

2022

BMJ Support Palliat Care

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ObjectivesPatients with prostate cancer (PCa) benefit from regular exercise, but it is difficult for patients to maintain an exercise regime. We examined two exercise programmes that have proven to be self-sustaining with the goal of identifying features they share that may contribute to their success.MethodsWe compared the FC Prostata football (soccer) league in Denmark and the ‘Butts in a Boat’ (BIAB) dragon-boating team in Canada. The FC Prostata Project Coordinator and the BIAB team leaders provided information on their programmes’ history and structure.ResultsBoth programmes are team-based with regularly scheduled intense exercise at their core. In both cases, social activities evolved spontaneously, starting with the men going out for food and/or drinks after practices. The sustainability of these programmes may be driven by the regular socialisation linked to the fitness activities.ConclusionsOur case studies suggest that exercise programmes for PCa patients may have a good chance of being self-sustaining, if they are: (1) centred around intense exercise, (2) of a team nature, (3) structured to promote egalitarianism and avoid one-on-one competition within teams, yet (4) have some competitions between teams. The data suggest that informal social activities organised by patients after team practices may be important for building fellowship and strengthening patients’ commitment to exercise both for themselves and for their team members.

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Barriers and facilitators related to undertaking physical activities among men with prostate cancer: a scoping review

Cited by 20 publications

References 111 publications

Exercise as a supportive care strategy in men with prostate cancer receiving androgen deprivation therapy at a regional cancer centre: a survey of patients and clinicians

Exercise as a supportive care strategy in men with prostate cancer receiving androgen deprivation therapy at a regional cancer centre: a survey of patients and clinicians

An Investigation into the Physical Activity Experiences of People Living with and beyond Cancer during the COVID-19 Pandemic

Case studies on psychosocial factors that help make exercise programmes for prostate cancer patients self-sustaining

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