Abstract
The present study aimed to establish exercise preferences, barriers, and perceived benefits among head and neck cancer survivors, as well as their level of interest in participating in an exercise program. Patients treated for primary squamous cell carcinoma of the head and neck between 2010 and 2014 were identified from the hospital database and sent a postal questionnaire pack to establish exercise preferences, barriers, perceived benefits, current physical activity levels, and quality of life. A postal reminder was sent to non-responders 4 weeks later. The survey comprised 1021 eligible patients of which 437 (43%) responded [74% male, median (interquartile range) age, 66 (60–73) years]. Of the respondents, 30% said ‘Yes’ they would be interested in participating in an exercise program and 34% said ‘Maybe’. The most common exercise preferences were a frequency of three times per week, moderate-intensity, and 15–29 min per bout. The most popular exercise types were walking (68%), flexibility exercises (35%), water activites/swimming (33%), cycling (31%), and weight machines (19%). Home (55%), outdoors (46%) and health club/gym (33%) were the most common preferred choices for where to regularly exercise. Percieved exercise benefits relating to improved physical attributes were commonly cited, whereas potential social and work-related benefits were less well-acknowledged. The most commonly cited exercise barriers were dry mouth or throat (40%), fatigue (37%), shortness of breath (30%), muscle weakness (28%) difficulty swallowing (25%), and shoulder weakness and pain (24%). The present findings inform the design of exercise programs for head and neck cancer survivors.
Highlights
A mounting body of scientific evidence has shown that physical exercise improves aerobic fitness, strength, physical activity levels, and quality of life, and reduces fatigue in cancer survivors during and post treatment [1,2,3]
The survey sample (January 2010–October 2014) comprised 1021 eligible head and neck cancer survivors of which 437 (43%) responded, 7 of these were omitted from the analyses due to scarcity of questionnaire responses
Lower response was noted for participants aged under 55 years (29%) and over 85 years (36%), but the response was typically 36–50% with no obvious biases when stratified by gender, time from diagnosis, tumour site, squamous cell carcinoma diagnosis, clinical TN staging, treatment group and surgical free-flap status
Summary
A mounting body of scientific evidence has shown that physical exercise improves aerobic fitness, strength, physical activity levels, and quality of life, and reduces fatigue in cancer survivors during and post treatment [1,2,3]. Symptoms consistent with other cancer types include pain, depression, fatigue, and intolerance to physical activity [10, 11] Other symptoms such as weight loss, head and neck oedema, dry mouth, mouth sores, dysphagia, and shoulder pain and dysfunction are specific to or more dominant in head and neck cancer [10, 12]. Another notable consideration is that individuals presenting with head and neck cancer historically are typically older, with prolonged exposure to smoking tobacco and high levels of alcohol consumption [13]. The cancer-specific symptoms and heterogeneity in head and neck cancer cohorts make the identification of evidence-based exercise guidelines an important challenge for the future
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