Perspectives and experiences of leisure-time physical activity in adults with stage 4 cancer: a qualitative interpretive-description study

Abstract

Purpose

Leisure-time physical activity (LTPA) can be beneficial for individuals with advanced cancer, but little is known on how to tailor rehabilitation strategies targeting LTPA in cancer care. Our objective was to explore perspectives and experiences of LTPA in people with stage 4 cancer.

Materials and methods

Guided by interpretive-description methodology, our qualitative study consisted of individual, semi-structured interviews with 20 Canadian adults diagnosed with stage 4 cancer. Interviews were transcribed verbatim and analyzed inductively.

Results

The participants’ median age was 51.5 (range, 35-73) years. Cancer types included breast (n = 12), lung (n = 4), and other (n = 4). Participants highlighted their experiences of LTPA as diverse and complex, impacted by individual and cancer-related factors. They emphasized being intentional with LTPA through activity planning and modification. LTPA participation was linked to physical well-being, social connections, and meanings of accomplishment and loss. Many participants desired personalized support related to LTPA, that is integrated, interprofessional, and accessible in cancer care.

Conclusion

The experiences of LTPA for people with stage 4 cancer are personal and connected to health and psychosocial meanings. Further efforts in rehabilitation are needed to address the challenges faced by people with advanced cancer and optimize safe, meaningful participation in LTPA.

IMPLICATIONS FOR REHABILITATION

• Experiences of leisure-time physical activity in individuals with stage 4 cancer are personal and linked to health benefits and psychosocial meanings.

• Activity participation frequently involves consideration of cancer-related symptoms, management of risks, and intentional planning and modification of activities.

• Trained rehabilitation professionals integrated in cancer care may be well suited to support people with stage 4 cancer through personalized activity recommendations.

• This research can help inform future clinical, research, and educational efforts in rehabilitation aimed at targeting physical activity in individuals with advanced cancer.

Keywords:

• Physical activity
• exercise
• advanced cancer
• palliative care
• rehabilitation

Acknowledgements

The authors thank our study participants for sharing their valuable time and experiences to support our research. The authors also appreciate the contributions of Marie-Christine Ranger and Angela Yung, as well as the Ottawa Regional Cancer Foundation, Breast Rehab, Hope & Cope, and Lung Cancer Advocacy Group Breath Hope, for their assistance with the study design and participant recruitment.

Author contributions

All authors made substantial contributions to the design (SMS, RT, JK, KTA, SP), data acquisition (SMS), analysis (SMS, RT, JK), and manuscript preparation (SMS, RT, JK, KTA, SP).

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

1 Descriptive characteristics associated with the participant quotes are limited to broad categories of age and primary cancer type (breast or non-breast cancer) in order to preserve anonymity of the individuals.

Additional information

Funding

The authors declare that no funds or grants were received to conduct this research. During the course of the study, the primary researcher (SMS) was supported in her graduate studies by the Ontario Graduate Scholarship and the University of Ottawa Excellence Scholarship.