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.

Autor: Elbourne H; Rural Clinical School, University of New South Wales, Albury Campus, Albury, NSW, 2640, Australia., Soo WK; Eastern Health Clinical School, Monash University, Box Hill, VIC, Australia.; Department of Cancer Services, Eastern Health, Box Hill, VIC, Australia.; Aged Medicine Program, Eastern Health, Box Hill, VIC, Australia., O'Reilly V; The Border Cancer Hospital, Albury Wodonga Regional Cancer Centre, Albury, NSW, 2640, Australia., Moran A; Department of Rural Health, University of Melbourne, Albury, NSW, Australia., Steer CB; Rural Clinical School, University of New South Wales, Albury Campus, Albury, NSW, 2640, Australia. csteer@bordermedonc.com.au.; Border Medical Oncology, Albury Wodonga Regional Cancer Centre, Albury, NSW, 2640, Australia. csteer@bordermedonc.com.au.
Jazyk: angličtina
Zdroj: Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer [Support Care Cancer] 2022 Feb; Vol. 30 (2), pp. 1379-1389. Date of Electronic Publication: 2021 Sep 14.
DOI: 10.1007/s00520-021-06512-2
Abstrakt: 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.
(© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
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