Objectives
Reduced physical functioning is a common sequela of treatment for oesophageal cancer. Exercise can be an effective intervention to ameliorate treatment related physical and psychological problems experienced. However it is unknown whether patients are aware of the role that exercise can play in enhancing recovery. The aims of this study were to explore patients’ knowledge and understanding of the role of exercise during cancer treatment and to identify patient reported barriers to exercise.
Methods
A qualitative descriptive study design was used. Patients receiving curative multimodal treatment for oesophageal cancer were purposively selected to complete individual semi-structured interviews. The semi-structured interviews were organised around an interview schedule which contained the topics to be covered during the course of the interview. Questions were designed to be simple, open-ended and flexible. Interviews were recorded using a digital voice recorder and data was transcribed verbatim. Thematic content analysis was used as a method for identifying, analysing and reporting patterns or themes within data. Patterns were identified through a rigorous process of data familiarisation, data coding, theme development and theme revision. An inductive, semantic approach was chosen, in which the themes are strongly linked to the data.
Results
Nine patients (n=7 men), mean age 62 (SD 6.31) years, who had completed neoadjuvant therapy and were scheduled for surgery completed interviews. While patients recognised that exercise is generally beneficial, knowledge of exercise guidelines was poor and patients were unaware of some of the wider ranging benefits of exercise such as the role of physical activity to reduce cancer related fatigue. Both disease specific and general barriers to exercise were described. The primary disease specific barriers were quite unique to oesophageal cancer and included weight loss and reduced energy levels due to changes in diet and eating habits.
Conclusion
Patients with oesophageal cancer patients demonstrate a poor understanding of the benefits of exercise during cancer treatment, in addition to facing a number of barriers to physical activity. These results suggest potential targets for intervention to influence physical activity levels in this cohort. Physiotherapists as exercise specialists are ideally placed to provide interventions to improve activity levels across the cancer continuum and therefore may need to play a larger role in this area in future.
Ethical Approval
Yes – SJH/AMNCH Ethics Committee.
