Are We on the Same Page? Patient and Provider Perceptions About Exercise in Cancer Care: A Focus Group Study
Abstract
Background: Physical activity (PA) during and after cancer treatment can help with symptom management and reduce the risk of cancer recurrence. However, it is unclear what constitutes an optimal exercise program. In addition, provider and patient barriers exist to the recommendation and adoption of exercise as part of a cancer treatment plan. The goal of this study was to determine how providers and patients feel about exercise during cancer treatment and explore what the barriers to implementing such a program might be. Patients and Methods: Focus groups and interviews were held with patients with malignancy, both metastatic and nonmetastatic, and oncology providers. In total, 20 patients participated in either a focus group or an individual interview and 9 providers contributed to the focus group. An equal number of patients (n=10) were interviewed as attended a focus group. Audiotaped sessions were transcribed verbatim. Theme identification was independently coded by 4 coders and synthesized as a group. Results: Neither patient group recalled PA instruction from oncology providers during their cancer treatment. Most participants (95%) felt exercise is important during cancer treatment, citing overall well-being benefits versus improved disease outcome. Most patients (80%) preferred a home-based exercise program provided by the oncologist. Fatigue was the most cited barrier to regular exercise during treatment (50%). All providers acknowledged benefits of PA to patients, but not universally for all. More than half of providers (55%) preferred a referral system for exercise programs. Clinic visit time constraints and a perceived lack of expertise in the area of PA were common barriers to making exercise recommendations a routine part of the treatment plan. Conclusions: Patients with cancer and oncologists recognize the benefits of PA during treatment. Disagreement exists between to whom, how, and where exercise plans should be disseminated and implemented.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Observed barriers to clinicians referring patients to exercise programming include lack of awareness of the potential value of exercise in cancer populations, uncertainty regarding the safety or suitability of exercise for a particular patient, lack of awareness regarding available programs, need for education and skills development for making referrals, and a belief that referrals to exercise编程
“Observed barriers to clinicians referring patients to exercise programming include lack of awareness of the potential value of exercise in cancer populations, uncertainty regarding the safety or suitability of exercise for a particular patient, lack of awareness regarding available programs to help facilitate exercise in cancer populations, need for education and skills development for making”
From Exercise is medicine in oncology: Engaging clinicians to help patients move through cancer (2019) · cites this paper as [24]
Cites
Riding the Crest of the Teachable Moment: Promoting Long-Term Health After the Diagnosis of Cancer
Demark‐Wahnefried, W., Aziz, N. M., Rowland, J. H., & Pinto, B. M. (2005) · Journal of Clinical Oncology · doi:10.1200/jco.2005.01.230 · Cited by 1,114 · see citing works
Exercise Counseling and Programming Preferences of Cancer Survivors
Jones, L. W., & Courneya, K. S. (2002) · Cancer Practice · doi:10.1046/j.1523-5394.2002.104003.x · Cited by 261 · see citing works
Practical clinical interventions for diet, physical activity, and weight control in cancer survivors
Demark‐Wahnefried, W., Rogers, L. Q., Alfano, C. M., Thomson, C. A., Courneya, K. S., Meyerhardt, J. A., Stout, N. L., Kvale, E., Ganzer, H., & Ligibel, J. A. (2015) · CA: A Cancer Journal for Clinicians · doi:10.3322/caac.21265 · Cited by 251 · see citing works
Balogh, E. P., Ganz, P. A., Murphy, S. B., Nass, S. J., FERRELL, B. R., & Stovall, E. L. (2011) · The Oncologist · doi:10.1634/theoncologist.2011-0252 · Cited by 148 · see citing works
Jones, L. W., Courneya, K. S., Peddle‐McIntyre, C. J., & Mackey, J. R. (2005) · Supportive Care in Cancer · doi:10.1007/s00520-005-0805-8 · Cited by 131 · see citing works
Exercise Interventions During Cancer Treatment: Biopsychosocial Outcomes
Courneya, K. S. (2001) · Exercise and Sport Sciences Reviews · doi:10.1097/00003677-200104000-00004 · Cited by 120 · see citing works
Exercise Discussions During Cancer Treatment Consultations
Jones, L. W., & Courneya, K. S. (2002) · Cancer Practice · doi:10.1046/j.1523-5394.2002.102004.x · Cited by 108 · see citing works
Influence of Cardiorespiratory Fitness on Lung Cancer Mortality
Sui, X., Lee, D.-C., Matthews, C. E., Adams, S. A., Hébert, J. R., Church, T. S., Lee, C., & Blair, S. N. (2010) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0b013e3181c47b65 · Cited by 73 · see citing works
Physical Activity Preferences Among a Population-Based Sample of Colorectal Cancer Survivors
McGowan, E. L., Speed-Andrews, A. E., Blanchard, C. M., Rhodes, R. E., Friedenreich, C. M., Culos-Reed, S. N., & Courneya, K. S. (2012) · Oncology nursing forum · doi:10.1188/13.onf.44-52 · Cited by 70 · see citing works
Physical activity among cancer survivors: a literature review.
Szymlek‐Gay, E. A., Richards, R., & Egan, R. (2011) · PubMed · Cited by 61 · see citing works
Park, J., Oh, M., Yoon, Y. J., Lee, C. W., Jones, L. W., Kim, S. I., Kim, N. K., & Jeon, J. Y. (2015) · BMC Cancer · doi:10.1186/s12885-015-1250-9 · Cited by 56 · see citing works
Alfano, C. M., Klesges, R. C., Murray, D. M., Bowen, D. J., McTiernan, A., Weg, M. W. V., Robinson, L. A., Cartmel, B., Thornquist, M. D., Barnett, M. J., et al. (2004) · Cancer Epidemiology Biomarkers & Prevention · doi:10.1158/1055-9965.2233.13.12 · Cited by 54 · see citing works
Murnane, A., Geary, B., & Milne, D. (2011) · Supportive Care in Cancer · doi:10.1007/s00520-011-1167-z · Cited by 30 · see citing works
Exercise Interventions During Cancer Treatment: Biopsychosocial Outcomes
Courneya, K. S. (2001) · Exercise and Sport Sciences Reviews · doi:10.1249/00003677-200104000-00004 · Cited by 12 · see citing works
Demark-Wahnefried, W., Peterson, B., McBride, C., Lipkus, I., & Clipp, E. (2000) · Cancer · doi:10.1002/(sici)1097-0142(20000201)88:3
Flagged first, then by citations
Cited by
Sorted by citations
Exercise is medicine in oncology: Engaging clinicians to help patients move through cancer
Schmitz, K. H., Campbell, A. M., Stuiver, M. M., Pinto, B. M., Schwartz, A. L., Morris, G. S., Ligibel, J. A., Cheville, A., Galvão, D. A., Alfano, C. M., et al. (2019) · CA: A Cancer Journal for Clinicians · doi:10.3322/caac.21579 · Cited by 789 · see citing works
A Systematic Review of Exercise Systematic Reviews in the Cancer Literature (2005‐2017)
Stout, N. L., Baima, J. A., Swisher, A. K., Winters‐Stone, K. M., & Welsh, J. A. (2017) · PM&R · doi:10.1016/j.pmrj.2017.07.074 · Cited by 409 · see citing works
Elshahat, S., Treanor, C., & Donnelly, M. (2021) · International Journal of Behavioral Nutrition and Physical Activity · doi:10.1186/s12966-021-01116-9 · Cited by 234 · see citing works
Physical activity programming and counseling preferences among cancer survivors: a systematic review
Wong, J. N., McAuley, E., & Trinh, L. (2018) · International Journal of Behavioral Nutrition and Physical Activity · doi:10.1186/s12966-018-0680-6 · Cited by 219 · see citing works
Kennedy, M. A., Bayes, S. J., Newton, R. U., Zissiadis, Y., Spry, N. A., Taaffe, D. R., Hart, N. H., & Galvao, D. A. (2021) · Journal of Cancer Survivorship · doi:10.1007/s11764-021-01080-0 · Cited by 112 · see citing works
Groen, W. G., van Harten, W. H., & Vallance, J. K. (2018) · Cancer Treatment Reviews · doi:10.1016/j.ctrv.2018.07.012 · Cited by 89 · see citing works
Roberts, K. E., Rickett, K., Feng, S., Vagenas, D., & Woodward, N. E. (2020) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd012988.pub2 · Cited by 67 · see citing works
Development, implementation, and effects of a cancer center's exercise‐oncology program
Mina, D. S., Au, D., Auger, L. E., Alibhai, S. M. H., Matthew, A., Sabiston, C. M., OH, P. I., Ritvo, P., Chang, E. B., & Jones, J. M. (2019) · Cancer · doi:10.1002/cncr.32297 · Cited by 52 · see citing works
Ramsey, I., Chan, A., Charalambous, A., Cheung, Y. T., Darling, H., Eng, L., Grech, L., Hart, N. H., Kirk, D., Mitchell, S. A., et al. (2022) · Supportive Care in Cancer · doi:10.1007/s00520-022-07342-6 · Cited by 45 · see citing works
Golubić, M., Schneeberger, D. L., Kirkpatrick, K., Bar, J., Bernstein, A., Weems, F., Ehrman, J. P., Perko, J., Doyle, J., & Roizen, M. F. (2018) · The Journal of Alternative and Complementary Medicine · doi:10.1089/acm.2018.0193 · Cited by 38 · see citing works
Gentry, A., Erickson, K. I., Sereika, S. M., Casillo, F. E., Crisafio, M. E., Donahue, P. T., Grove, G., Marsland, A. L., Watt, J. C., & Bender, C. M. (2018) · Contemporary Clinical Trials · doi:10.1016/j.cct.2018.02.012 · Cited by 37 · see citing works
Kennedy, M. A., Bayes, S. J., Newton, R. U., Zissiadis, Y., Spry, N. A., Taaffe, D. R., Hart, N. H., Davis, M., Eiszele, A., & Galvao, D. A. (2020) · International Journal of Behavioral Nutrition and Physical Activity · doi:10.1186/s12966-020-01032-4 · Cited by 35 · see citing works
Exercise for managing cancer- and treatment-related side effects in older adults
Loh, K. P., Lin, P., Uth, J., Quist, M., Klepin, H. D., & Mustian, K. M. (2018) · Journal of Geriatric Oncology · doi:10.1016/j.jgo.2018.03.003 · Cited by 29 · see citing works
Nauta, J., van Nassau, F., Bouma, A. J., Krops, L. A., van der Ploeg, H. P., Verhagen, E. A. L. M., van der Woude, L. H. V., van Keeken, H. G., Buffart, L. M., Diercks, R. L., et al. (2022) · BMJ Open · doi:10.1136/bmjopen-2021-052920 · Cited by 25 · see citing works
Quinn, S. E., Crandell, C. E., Blake, M. E., Bontrager, A. M., Dempsey, A. G., Lewis, D. J., Hamm, J. T., Flynn, J. M., Smith, G. S., & Wingard, C. J. (2020) · Physical Therapy · doi:10.1093/ptj/pzz192 · Cited by 19 · see citing works
Balneaves, L. G., Truant, T. L. O., Patten, C. L. V., Kirkham, A. A., Waters, E., & Campbell, K. L. (2020) · Journal of Clinical Medicine · doi:10.3390/jcm9092815 · Cited by 16 · see citing works
Alderman, G., Keegan, R. J., Semple, S., & Toohey, K. L. (2020) · PLoS ONE · doi:10.1371/journal.pone.0241668 · Cited by 13 · see citing works
Returning to Sport: Female Athletes Living with and beyond Cancer
Schwartz, A. L., & Terry, C. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18158151 · Cited by 9 · see citing works
Exercise Professionals in the Cancer Center: Experiences, Recommendations, and Future Research
Cheema, B. S., Fairman, C. M., & Marthick, M. (2019) · Translational Journal of the American College of Sports Medicine · doi:10.1249/tjx.0000000000000088 · Cited by 9 · see citing works
Roberts, K. E., Rickett, K., Vagenas, D., & Woodward, N. E. (2018) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd012988 · Cited by 8 · see citing works
Wearable Monitors Facilitate Exercise in Adult and Pediatric Stem Cell Transplant
Pottebaum, E., Warmoth, A., Ayyappan, S. R., Dickens, D. S., Jethava, Y. S., Modi, A. J., Tomasson, M. H., Carr, L. J., & Bates, M. L. (2021) · Exercise and Sport Sciences Reviews · doi:10.1249/jes.0000000000000258 · Cited by 7 · see citing works
Gupta, P., Hodgman, C. F., Alvarez‐Florez, C., Schadler, K., Markofski, M. M., O’Connor, D. P., & LaVoy, E. C. P. (2022) · Frontiers in Physiology · doi:10.3389/fphys.2022.1039988 · Cited by 5 · see citing works
Lally, P. J., Kennedy, F., Smith, S., Beeken, R. J., Buck, C., Thomas, C., Counsell, N., Wyld, L., Martin, C., Williams, S. V., et al. (2024) · Cancer Medicine · doi:10.1002/cam4.7124 · Cited by 4 · see citing works
Sport in the Laryngectomized Patient: A Literature Review and Single Case Presentation
Mesolella, M., Allosso, S., Salerno, G., & Motta, G. (2023) · Journal of Personalized Medicine · doi:10.3390/jpm13060982 · Cited by 5 · see citing works
Using Cognitive Interviewing to Design Interventions for Implementation in Oncology Settings
Hirschey, R., Nance, J., Wangen, M., Bryant, A. L., Wheeler, S. B., Herrera, J., & Leeman, J. (2021) · Nursing Research · doi:10.1097/nnr.0000000000000498 · Cited by 5 · see citing works
Spring, B. J., Garcia, S. F., Daly, E., Jacobs, M. L., Jayeoba, M., Jordan, N., Kircher, S. M., Kocherginsky, M., Mazzetta, R., Pollack, T., et al. (2024) · JNCI Monographs · doi:10.1093/jncimonographs/lgae020 · Cited by 4 · see citing works
Ulrich, G. R., Nogg, K. A., Freeman, S. Z., & Ranby, K. W. (2022) · Translational Behavioral Medicine · doi:10.1093/tbm/ibac024 · Cited by 3 · see citing works
Bastas, D., Tabaczynski, A., Whitehorn, A., & Trinh, L. (2023) · Supportive Care in Cancer · doi:10.1007/s00520-023-07813-4 · Cited by 3 · see citing works
Kizub, D., Raber, M. R., Baum, M. L., Ma, H. Y., Patel, T. A., Rechis, R., LaRue, D. M., Ho-Pham, T. T., Oestman, K. B., Walsh, M. T., et al. (2025) · JCO Oncology Practice · doi:10.1200/op.24.00431 · Cited by 3 · see citing works
Exercise is Medicine! Why are People not Buying into the Prescription?
Cavallini, M. F., & Dyck David, J. (2020) · Journal of Family Medicine and Disease Prevention · doi:10.23937/2469-5793/1510125 · Cited by 3 · see citing works
Jones, J. M., Andrawes, R. R., Weller, M. A., Lam, A., Shapiro, G. K., Li, M., Rodin, D. L., & Avery, L. M. (2025) · Cancer Medicine · doi:10.1002/cam4.71046 · Cited by 2 · see citing works
Schwartz, A. L., Helling, W., Griffin, S., Mikuls, S., & Weber, B. (2024) · Physical Activity Exercise and Cancer · doi:10.61486/zqos1684 · Cited by 2 · see citing works
From Diagnosis to Recovery: The Life-Changing Benefits of Exercise for Cancer Patients
Koper, M., Bochenek, O., Nowak, A., Kałuża, J. A., Konaszczuk, A., Ratyna, K., Kozyra, O., Szypuła, Z., Paluch, K., & Skarbek, M. (2024) · Quality in Sport · doi:10.12775/qs.2024.20.54212 · Cited by 2 · see citing works
Gorzelitz, J., Kennedy, M. A., Dittus, K. L., Mansfield, S., Wonders, K. Y., Hansen, P. A., Coletta, A. M., Iyengar, N. M., Wood, K. C., Schwartz, A. L., et al. (2025) · Translational Journal of the American College of Sports Medicine · doi:10.1249/tjx.0000000000000301 · Cited by 2 · see citing works
Cesnik, R., Kunstler, B., Toohey, K. L., Freene, N., & Semple, S. (2025) · Supportive Care in Cancer · doi:10.1007/s00520-025-10174-9 · Cited by 1 · see citing works
Wilson, O. W. A., Wojcik, K. M., Kerr, E. M., Rivera, I., Tian, E., Schneider, J. D., Brick, R. S., Matthews, C. E., Tamura, K., Rogers, L. Q., et al. (2026) · Supportive Care in Cancer · doi:10.1007/s00520-026-10358-x · Cited by 1 · see citing works
Frankinouille, R., Vanhoutte, G., Stassijns, G., Coster, C., Roelant, E., Rasschaert, M. A., Gielen, J., Altintas, S., & Peeters, M. (2020) · Journal of Rehabilitation Medicine – Clinical Communications · doi:10.2340/20030711-1000030 · Cited by 1 · see citing works
Physical Activity and Exercise Adherence in People With Hematologic Malignancies
Hacker, E. D. (2019) · The Journal for Nurse Practitioners · doi:10.1016/j.nurpra.2019.04.016 · Cited by 1 · see citing works
High-Intensity Interval Training in the Oncology Population
Chongaway, A., & Doherty, D. J. (2022) · Rehabilitation Oncology · doi:10.1097/01.reo.0000000000000300 · Cited by 1 · see citing works
Schwartz, A. L., Helling, W., Griffin, S., Mikuls, S., & Weber, B. (2023) · doi:10.2196/preprints.45685
BÖLÜKBAŞ, M. G., & Vatansever, Ş. (2023) · Ankara Üniversitesi Beden Eğitimi ve Spor Yüksekokulu SPORMETRE Beden Eğitimi ve Spor Bilimleri Dergisi · doi:10.33689/spormetre.1224290
Dean, K., Stamp, E., & Morris, M. A. (2024) · Research Square · doi:10.21203/rs.3.rs-3870757/v1
Burgess, N., Retica, S., Capron, K., Dionysus, A., Edbrooke, L., Berney, S. C., Berlowitz, D. J., & Graco, M. (2025) · Supportive Care in Cancer · doi:10.1007/s00520-024-09048-3
Maurer, T., Belau, M. H., Zyriax, B., Welsch, G. H., Jagemann, B., Chang‐Claude, J., Daubmann, A., Buchholz, A., Fierenz, A., Glismann, K., et al. (2025) · Gynecologic Oncology · doi:10.1016/j.ygyno.2025.10.005
Elshahat, S., Treanor, C., & Donnelly, M. (2021) · Figshare · doi:10.6084/m9.figshare.14379434
Elshahat, S., Treanor, C., & Donnelly, M. (2021) · Figshare · doi:10.6084/m9.figshare.14379431
Physical activity and exercise in individuals dealing with cancer in the Free State: A KAP study
Barnes, R. Y., Welman, J., & van Rooyen, F. C. (2025) · South African Journal of Physiotherapy · doi:10.4102/sajp.v81i1.2186
“It’s adjusting the mindset”: physical activity participation during chemotherapy
Bertram, J. J., Pickens, N., & T., G. H. (2026) · Supportive Care in Cancer · doi:10.1007/s00520-026-10628-8
Beets, G., Bol, N., Ollerton, R. D., Folkvord, F., Stuiver, M. M., Deasy, G., & Krahmer, E. (2026) · Behavioral Medicine · doi:10.1080/08964289.2026.2677133
- Authors
- Smaradottir, A., Smith, A. L., Borgert, A. J., & Oettel, K. R.
- Affiliations
- Gundersen Medical Foundation (US)
- Gundersen Health System (US)
- ORCID
- Borgert, Andrew J.
- Venue
- Journal of the National Comprehensive Cancer Network
- Publisher
- Harborside Press, LLC
- Published
- 2017-05
- Volume
- 15
- Issue
- 5
- Pages
- 588-594
- ISSN
- 1540-1405 (ISSN-L)
- 1540-1413
- OpenAlex
- W2611956337
- Cited by
- 49
- References
- 14
- Citations by year
- 2026: 3 · 2025: 7 · 2024: 5 · 2023: 4 · 2022: 5 · 2021: 7 · 2020: 7 · 2019: 4 · 2018: 6 · 2017: 1
- FWCI
- 2.17
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of the National Comprehensive Cancer Network (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Health Sciences › Medicine › Oncology › Cancer Risks and Factors
- Keywords
- exercise during cancer treatment, physical activity, barriers to exercise, fatigue, home-based exercise, exercise referral, oncology providers, cancer patients, metastatic cancer, symptom management, cancer recurrence risk
- MeSH terms
- Aged, Cancer Care Facilities, Exercise Therapy, Female, Humans, Male, Middle Aged, Perception, Physician-Patient Relations, Focus Groups
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review