Do physical activity levels in the cancer population recover without intervention? An observational study

Abstract

Background: National UK directives expect physical activity (PA) to be included in cancer patients’ management due to recognition of its wide-ranging benefit. Local implementation is inconsistent and remains a challenge.Nationally, only 29% of females and 39% of males in England met American College of Sports Medicine (ACSM) exercise recommendations. Those receiving cancer treatments may be less likely to meet exercise recommendations at the completion of primary cancer treatment. Purpose: To evaluate PA levels in a representative sample of cancer survivors post primary treatment (end-of-treatment: EOT) and 4 months post EOT as part of determining their natural recovery trajectory to inform future development of services. Methods:A consecutive, representative sample of 76 survivors with breast, prostate, gynaecological, colorectal and lymphoma cancer (mean age 64.7 years, SD= 11.67) diagnosed and treated at a regional cancer centre in London, UK were measured between November 2012 and March 2013 at EOT. The short form International Physical Activity Questionnaire (IPAQ-SF) was our primary measure of patient self-reported PA levels. Patient demographics and characteristics represented secondary measures. Results: IPAQ-SF scores revealed 85% (n= 71) met exercise recommendations at EOT when translated to the ACSM recommendations.At 4months therewas no proportional difference (n= 53, 85%). There were no statistically significant associations between PA change and gender or tumour type. Overall, our results showed an unexpected over-reporting of recommended PA levels both at EOT and 4 months post EOT compared with the unimpaired population. Conclusion(s):Our results show that self reported PA levels do not change 4 months after EOT. The validity of the IPAQ-SF in translating PA with respect to exercise recommendations in cancer survivors is questionable. This may be secondary to erroneous reporting of low level activity included e.g. walking which may have inflated PA levels. There remains debate about operationalizing PA and other functional activities in this representative sample. Implications:Our data indicates that the use of the IPAQSF should be carefully considered in reportingPA levels in the context of recommended PA levels in the cancer population at the end of primary treatment. There is an urgent need for the professional community to reach consensus on what does and does not constitute PA in impaired populations.