Promotion of Physical Activity & Motivation in cancer survivors

There's lots of research that demonstrates exercise is beneficial to those that have been diagnosed with cancer but the work that interests me the most is around how we can integrate physical activity opportunities into the cancer care pathway.

What motivates those with cancer to be active? What barriers to increased activity exist? What are the best ways to encourage people with cancer to be active as part of their recovery?

This page contains evidence and resources to address these questions.

Recommended Reading

Macmillan Cancer Support. (2016). What motivates people with cancer to get active: Understanding the motivations and barriers to physical activity in people living with cancer.[full text]

Macmillan Cancer Support. (2018). Move More: Integrating physical activity into cancer care (Evidence and guidance) [full text]

Further Reading

Aarnoudse,G.B. (2010) Physical activity during and after cancer treatment: Barriers, facilitators, predictors and adherence (MSc Thesis) Utrecht University: The Netherlands [full text]

Andrews, A., Rhodes, R., Blanchard, C., Culos-Reed, S., Friedenreich, C., Belanger, L. and Courneya, K. (2012), Medical, demographic and social cognitive correlates of physical activity in a population-based sample of colorectal cancer survivors. European Journal of Cancer Care, 21: 187–196. doi: 10.1111/j.1365-2354.2011.01290.x [abstract]

Blaney, J., Lowe-Strong, A., Rankin, J., Campbell, A., Allen, J., & Gracey, J. (2010). The cancer rehabilitation journey: barriers to and facilitators of exercise among patients with cancer-related fatigue. Physical therapy, 90(8), 1135-47. doi:10.2522/ptj.20090278 [full text]

Blaney, J. M., Campbell, A., & Gracey, J. H. (2011). Cancer survivors ’ exercise barriers , facilitators and preferences in the context of fatigue , quality of life and physical activity participation : a questionnaire – survey. Psycho-Oncology. doi:10.1002/pon [full text]

Bluethmann, S. M., Sciamanna, C. N., Winkels, R. M., Sturgeon, K. M., & Schmitz, K. H. (2018). Healthy Living After Cancer Treatment: Considerations for Clinical and Community Practice. American Journal of Lifestyle Medicine, 12(3), 215-219. https://doi.org/10.1177/1559827618755681

Bourke, L., Homer, K. E., Thaha, M. A., Steed, L., Rosario, D. J., Robb, K. A., ... & Taylor, S. J. C. (2014). Interventions to improve exercise behaviour in sedentary people living with and beyond cancer: a systematic review. British Journal of Cancer, 110(4), 831. https://doi.org/10.1038/bjc.2013.750

Brunet, J., Amireault, S., Chaiton, M., & Sabiston, C. M. (2014). Identification and prediction of physical activity trajectories in women treated for breast cancer.Annals of Epidemiology.[abstract]

Cantwell, M., Walsh, D., Furlong, B., Loughney, L., McCaffrey, N., Moyna, N., & Woods, C. (2019). Physical Activity Across the Cancer Journey: Experiences and Recommendations From People Living With and Beyond Cancer. Physical Therapy, pzz136. https://doi.org/10.1093/ptj/pzz136

Carmack Taylor, C. L., Demoor, C., Smith, M. a, Dunn, A. L., Basen-Engquist, K., Nielsen, I., Pettaway, C., et al. (2006). Active for Life After Cancer: a randomized trial examining a lifestyle physical activity program for prostate cancer patients. Psycho-oncology, 15(10), 847-62 [abstract]

Costanzo, E. S., Lutgendorf, S. K., & Roeder, S. L. (2011). Common-Sense Beliefs about Cancer and Health Practices Among Women Completing Treatment for Breast Cancer. Psychooncology, 20(1), 53–61. doi:10.1002/pon.1707.Common-Sense [full text]

Coups, E. J., Park, B. J., Feinstein, M. B., Steingart, R. M., Egleston, B. L., Wilson, D. J., & Ostroff, J. S. (2009). Correlates of physical activity among lung cancer survivors. Psycho-Oncology, 18, 395-404. [abstract]

Courneya, K.S., Karvinen, K.H. and Vallance, J.K.H. (2007) Exercise Motivation and Behavior Change In Feuerstein, M. Handbook of Cancer Survivorship Springer pp 113-132, DOI: 10.1007/978-0-387-34562-8_7 [full text]

Craike, M.J., Livingston, P.M. and Botti, M. (2010) An exploratory study of the factors that influence physical activity for prostate cancer survivors Supportive Care in Cancer Vol.19, No. 7, 1019-1028, DOI: 10.1007/s00520-010-0929-3 [abstract]

Daley, A.J., Bowden, S.J., Rea, D.W., Billingham, L. and Carmicheal, A.R. (2008) What advice are oncologists and surgeons in the United Kingdom giving to breast cancer patients about physical activity? International Journal of Behavioral Nutrition and Physical Activity 5:46 [full text]

Demark-Wahnefried, W., Aziz, N.M., Rowland, J.H. and Pinto, B.M. (2005) Riding the Crest of the Teachable Moment: Promoting Long-Term Health After the Diagnosis of Cancer J Clin Oncol Vol.23, No.24, 5814–5830.[full text]

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), 827–38. doi:10.1093/her/cyl159 [full text]

Finlay, A., Wittert, G., & Short, C. E. (2018). A systematic review of physical activity-based behaviour change interventions reaching men with prostate cancer. Journal of Cancer Survivorship, 12(4), 571-591. https://doi.org/10.1007/s11764-018-0694-8

Finne, E., Glausch, M., Exner, A. K., Sauzet, O., Stoelzel, F., & Seidel, N. (2018). Behavior change techniques for increasing physical activity in cancer survivors: a systematic review and meta-analysis of randomized controlled trials. Cancer Management and Research, 10, 5125. doi: 10.2147/CMAR.S170064

Grimmett, C., Foster, C., Bradbury, K., Lally, P., May, C. R., Myall, M., ... & Corbett, T. (2020). Exploring maintenance of physical activity behaviour change among people living with and beyond gastrointestinal cancer: a cross-sectional qualitative study and typology. BMJ open, 10(10), e037136. http://dx.doi.org/10.1136/bmjopen-2020-037136

Harriss, D. J., Cable, N. T., George, K., Reilly, T., Renehan, A. G., & Haboubi, N. (2007). Physical activity before and after diagnosis of colorectal cancer: disease risk, clinical outcomes, response pathways and biomarkers. Sports Medicine, 37(11), 947-60

Hefferon, K., Murphy, H., McLeod, J., Mutrie, N. and Campbell, A. (2013) Understanding barriers to exercise implementation 5-year post-breast cancer diagnosis: a large-scale qualitative study. Health Education Research. : 1–14. [Online]. Available from: doi:10.1093/her/cyt083 [full text]

Humpel, N., & Iverson, D. C. (2010). Sleep quality, fatigue and physical activity following a cancer diagnosis. European Journal of Cancer Care, 19(6), 761-8 [abstract]

Humpel, N., & Iverson, D. C. (2007). Depression and quality of life in cancer survivors: is there a relationship with physical activity? International Journal of Behavioral Nutrition and Physical Activity, 4(65), 1-10. [full text]

Irwin, M. L., Mctiernan, A., Bernstein, L., Gilliland, F. D., Baumgartner, R., Baumgartner, K. and Ballardbarbash, R. (2004) Physical Activity Levels among Breast Cancer Survivors. Med. Sci. Sports Exerc., Vol. 36, No. 9, pp. 1484–1491 [full text]

Jones, L. W. and Courneya, K. S. (2002), Exercise Counseling and Programming Preferences of Cancer Survivors. Cancer Practice, 10: 208–215. doi: 10.1046/j.1523-5394.2002.104003.x [abstract

Kampshoff, C. S., Jansen, F., van Mechelen, W., May, A. M., Brug, J., Chinapaw, M. J., & Buffart, L. M. (2014). Determinants of exercise adherence and maintenance among cancer survivors: a systematic review. International Journal of Behavioral Nutrition and Physical Activity, 11(1), 80. [full text]

Karvinen, K.H., Courneya, K.S., Campbell, K.L., Pearcey, R.G., Dundas, G., Capstick, V., et al (2007) Correlates of exercise motivation and behaviour in a population-based sample of endometrial cancer survivors: an application of the Theory of Planned Behavior. Int J Behav Nutr Phys Act 4:21[full text]Speed

Karvinen,K.H., McGourty, S., Parent, T., and Walker, P.R. (2011) Physical Activity Promotion Among Oncology Nurses Cancer Nursing doi: 10.1097/NCC.0b013e31822d9081 [abstract]

Karvinen,K.H., DuBose, K.D., Carney, B., and Allison, R.R. (2010) Promotion of Physical Activity Among Oncologists in the United States The Journal of Supportive Oncology Vol. 8, No.1 [full text]

Karvinen KH, Courneya KS, Campbell KL, Pearcey RG, Dundas G, Capstick V, et al.(2006) Exercise preferences of endometrial cancer survivors: a population-based study. Cancer Nurs 29(4):259-65.[abstract]

Karvinen KH, Courneya KS, Venner P, North S. (2007) Exercise programming and counseling preferences in bladder cancer survivors: a population-based study. J Cancer Surviv 1(1):27-34.[abstract]

Karvinen, K. H., McGourty, S., Parent, T., & Walker, P. R. (2012). Physical activity promotion among oncology nurses. Cancer nursing, 35(3), E41–8. doi:10.1097/NCC.0b013e31822d9081 [abstract]

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. doi:10.1186/1471-2407-10-406 [full text]

Kuijpers, W., Groen, W. G., Aaronson, N. K., & Harten, W. H. (2013). A Systematic Review of Web-Based Interventions for Patient Empowerment and Physical Activity in Chronic Diseases: Relevance for Cancer Survivors. Journal of medical internet research (electronic), 15(2), e37.[full text]

Liu, R.D.K. et al. (2011) Psychometric properties of two physical activity questionnaires, the AQuAA and the PASE, in cancer patients BMC Medical Research Methodology 11:30 http://www.biomedcentral.com/1471-2288/11/30 [full text]

Maddocks, M., Armstrong, S., & Ã, A. W. (2011). Exercise as a supportive therapy in incurable cancer: exploring patient preferences. Psycho-Oncology, 20, 173-178. [abstract]

May, A. M., Duivenvoorden, H. J., Korstjens, I., van Weert, E., Hoekstra‐Weebers, J. E., van den Borne, B., ... & Ros, W. J. (2008). The effect of group cohesion on rehabilitation outcome in cancer survivors. Psycho‐Oncology, 17(9), 917-925. [full text]

May, A. M., Van Weert, E., Korstjens, I., Hoekstra-Weebers, J. E. H. M., Van Der Schans, C. P., Zonderland, M. L., Mesters, I., et al. (2008). Improved physical fitness of cancer survivors: a randomised controlled trial comparing physical training with physical and cognitive-behavioural training. Acta Oncologica, 47(5), 825-34. [full text]

Milne, H.M., Wallman, K.E., Guilfoyle, A., Gordon, S., Corneya, K.S. (2008) Self-determination theory and physical activity among breast cancer survivors. Journal of Sport & Exercise Psychology, Vol.30, No.1, 23-38 [abstract]

Parker, N. H., Lee, R. E., O’Connor, D. P., Ngo-Huang, A., Petzel, M. Q., Schadler, K., ... & Fleming, J. B. (2019). Supports and Barriers to Home-Based Physical Activity During Preoperative Treatment of Pancreatic Cancer: A Mixed-Methods Study. Journal of Physical Activity and Health, 1(aop), 1-10. https://doi.org/10.1123/jpah.2019-0027

Rajotte, E. J., Jean, C. Y., Baker, K. S., Gregerson, L., Leiserowitz, A., & Syrjala, K. L. (2012). Community-based exercise program effectiveness and safety for cancer survivors. Journal of Cancer Survivorship, 6(2), 219-228.

Rogers, L. Q., Markwell, S., Hopkins-Price, P., Vicari, S., Courneya, K. S., Hoelzer, K., & Verhulst, S. (2011). Reduced Barriers Mediated Physical Activity Maintenance Among Breast Cancer Survivors. Methods, 33(2), 235-254 [full text]

Rogers, L. Q., Courneya, K. S., Shah, P., Dunnington, G., & Hopkins-Price, P. (2007). Exercise stage of change, barriers, expectations, values and preferences among breast cancer patients during treatment: a pilot study. European journal of cancer care, 16(1), 55-66. doi:10.1111/j.1365-2354.2006.00705.x [full text]

Rabin, C., Pinto, B. M., & Frierson, G. M. (2006). Mediators of a Randomized Controlled Physical Activity Intervention for Breast Cancer Survivors. Journal of Sport & Exercise Psychology, 28, 269-284.

Richards, M., Corner, J., & Maher, J. (2011). The National Cancer Survivorship Initiative: new and emerging evidence on the ongoing needs of cancer survivors. British journal of cancer, 105 Suppl 1(S1), S1–4. doi:10.1038/bjc.2011.416 [full text]

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.[full text]

Santa Mina, D., Sabiston, C. M., Au, D., Fong, A. J., Capozzi, L. C., Langelier, D., ... & Chang, E. (2018). Connecting people with cancer to physical activity and exercise programs: a pathway to create accessibility and engagement. Current Oncology, 25(2), 149. doi: 10.3747/co.25.3977

Schmidt, M. L., Østergren, P., Cormie, P., Ragle, A. M., Sønksen, J., & Midtgaard, J. (2019). “Kicked out into the real world”: prostate cancer patients’ experiences with transitioning from hospital-based supervised exercise to unsupervised exercise in the community. Supportive Care in Cancer, 27(1), 199-208. https://doi.org/10.1007/s00520-018-4306-y

Shang, J., Wenzel, J., Krumm, S., Griffith, K., & Stewart, K. (2012). Who will drop out and who will drop in: exercise adherence in a randomized clinical trial among patients receiving active cancer treatment. Cancer nursing, 35(4), 312–22. doi:10.1097/NCC.0b013e318236a3b3 [abstract]

Sherman, K., Heard, G., & Cavanagh, K. L. (2010). Psychological effects and mediators of a group multi-component program for breast cancer survivors. Journal of Behavioral Medicine, 33(5), 378-91. [full text]]

Speed-Andrews, A. E., & Courneya, K. S. (2012). Cancer Patients. In Acevedo, E.O. (Ed.), The Oxford Handbook of Exercise Psychology (Oxford Library of Psychology) New York: Oxford University Press.pp. 430-464 [google books]

Stanton, A.L. (2006) Psychosocial Concerns and Interventions for Cancer Survivors J Clin Oncol Vol. 24 , No.32, 5132-5137 [full text]

Stevinson, C., Tonkin, K., Capstick, V., Schepansky, A., Ladha, A. B., Valance, J. K., Faught, W., et al. (2009). A population-based study of the determinants of physical activity in ovarian cancer survivors. Journal of Physical Activity & Health, 6(3), 339-46. [abstract]

Stull, V.B., Snyder, D.C. and Demark-Wahefried, W. (2007) Lifestyle Interventions in cancer survivors: Designing Programs that meed the needs of this vulnerable and growing population J. Nutr. Vol. 137, No. 1 243S-248S [full text]

Thorsen, L., Gjerset, G. M., Loge, J. H., Kiserud, C. E., Skovlund, E., Fløtten, T., & Fosså, S. D. (2011). Cancer patients’ needs for rehabilitation services. Acta oncologica, 50(2), 212-22. [full text]

Underwood, J. M., Townsend, J. S., Stewart, S. L., Buchannan, N., Ekwueme, D. U., Hawkins, N. a, Li, J., et al. (2012). Surveillance of demographic characteristics and health behaviors among adult cancer survivors--Behavioral Risk Factor Surveillance System, United States, 2009. Morbidity and Mortality Weekly Report, 61(1), 1-23.