A Pilot Study to Explore the Role of Physical Activity as a Quality of Life Intervention in Advanced Cancer Patients

Background Information Cancer is one of the leading causes of mortality and morbidity worldwide[1]. The resultant morbidities of cancer and its treatment are manifold; common physiologic symptoms include pain, muscle weakness and fatigue, whereas common psychological symptoms include depression, anxiety and poor sense of well-being. As methods of cancer detection and treatment improve, survival is prolonged and the lifetime burden of these adverse effects increases[2]. Addressing these issues is critical towards maximizing quality of life, a multidimensional construct encompassing all physical and psychosocial factors[3].

Physical activity is one potential strategy for ameliorating quality of life in all phases of cancer and its treatment [4]. Increasing evidence indicates a role for physical activity in improving several aspects of physical and psychological well-being that may contribute to quality of life in cancer patients, including muscle strength, functional capacity, mood and self-esteem[5]. Not only does physical activity have proven benefits in terms of physical performance and fatigue in cancer survivors, it may improve the capacity for basic activities of daily living such that functional independence can be maintained as long as possible[6]. Although this has been demonstrated for early stage cancer survivors, there is limited evidence for the use of physical activity in the palliation of patients with actively progressive, advanced incurable cancer[7]. A few studies of exercise in advanced metastatic cancer patients have demonstrated benefits in quality of life outcomes, however small sample sizes have limited their generalizability to the larger end-stage cancer population[8-12]. There exists a critical need to more specifically identify exercise programmes targeted to advanced cancer patients' needs, interests and preferences[13].

Purpose The purpose of this pilot study is to explore the physical activity preferences and interests of actively progressive, advanced incurable cancer patients and to determine if there is any association between physical activity and quality of life in this population. The ultimate aim of this study is to provide preliminary data on which a subsequent intervention trial can be based if encouraging results are obtained.

Objectives

1. To describe advanced cancer patient's attitudes towards physical activity, self-efficacy for physical activity and programming preferences.
2. To examine the relationship between quality of life, medical and demographic variables, and physical activity in advanced cancer patients.
3. To identify which advanced cancer populations would be willing and able to participate in a physical activity intervention.