To successfully implement exercise programs for patients with metastatic breast cancer, services and education on expected benefits and how to overcome barriers should be aligned with patient preferences, values, and goals. Hence, gaining insight into patients’ perspectives on exercise and exercise programming is crucial.
In this cross-sectional survey, we recruited patients from 13 centers in the Netherlands, Germany, Poland, Spain, and Sweden. We collected data on patients’ knowledge about exercise and outcome expectations. We identified barriers to and facilitators for participation in exercise programs, and patients’ preferences for content and modes of exercise delivery.
420 patients completed the survey. Respondents were on average 56 years old and 70% had bone metastases. 65% reported having sufficient skills to engage in aerobic exercise, but only 34% did so for resistance exercise. Overall, respondents expected exercise to have multiple physical benefits, but a few expected exercise to worsen their pain (5%) or fatigue (4%). Feeling too tired (22%) and/or weak (23%) and not having access to an exercise program for cancer patients (26%) were the most prominent barriers. Facilitators for exercising regularly were previous positive physical (70%) and emotional (66%) experiences from exercising, and getting personalized advice from a physiotherapist (60%). Patients were most interested in walking and preferred exercising at a public gym, physiotherapy practice or outdoors, with inter-country differences. 56% did not know whether their insurance company reimburses exercise programs and only 9% would be willing to pay > €50 per month to participate.
A large proportion of patients with metastatic breast cancer reported not having the necessary skills to engage in regular exercise as recommended by current exercise guidelines for people with cancer. Patients may benefit from personalized advice and training facilities where they receive instructions and can practice safe and effective exercises. When implementing exercise interventions for patients with metastatic breast cancer, attention should be given to reimbursement and willingness-to-pay.
Clinical trial identification
Legal entity responsible for the study
Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital.
European Union’s Horizon 2020 research and innovation programme.
A.M. May: Financial Interests, Institutional, Advisory Role: COMPASS. K. Steindorf: Financial Interests, Personal, Expert Testimony, < €5,000: Institut National contre le cancer (INCA), Paris, France; Financial Interests, Personal, Expert Testimony, Member of Data Monitoring Board; < €1,000: Swiss Group for Clinical Research (SAAK), Switzerland; Financial Interests, Personal, Invited Speaker, < €1,000: Adviva, Heidelberg, Germany, Pierre Fabre, Freiburg, Germany, Takeda, Breast Cancer Care Center, Unna, Germany, Audi Health Care Insurance, Ingolstadt, Germany, University of Mainz, Germany; Financial Interests, Personal, Invited Speaker, Lecturer fee in Master Course, < €2,000: University of Heidelberg, Germany; Financial Interests, Personal, Expert Testimony, compensation of travel costs, no further fees: German Research Foundation (DFG), Bonn, Germany; Financial Interests, Personal, Expert Testimony, < €1,000: University of Vienna, Vienna, Austria. All other authors have declared no conflicts of interest.