Follow-up study at Gundersen looks at exercise and cancer care

A Gundersen Medical Foundation study, "Are We on the Same Page? Patient and Provider Perceptions about Exercise in Cancer Care: A Focus Group Study," recently garnered the attention of medical oncologists across the nation.

Gundersen researchers studying physical activity recommendations and cancer care include (L-R): Agnes Smaradottir, MD; Andrew Borgert; Angela Smith; and Kurt Oettel, MD.The study, published in the May 2017 issue of JNCCN – Journal of the National Comprehensive Cancer Network, found that patients with cancer believe exercise is an important part of their treatment, but oncologists do not typically offer physical activity recommendations.

Gundersen medical oncologist and principle investigator Agnes Smaradottir, MD; medical oncologist Kurt Oettel, MD; biostatistician Andrew Borgert; and academic researcher Angela Smith, interviewed 20 patients (ages 45 and older), including 10 patients with stage IV metastatic cancer who were undergoing treatment. The research team also interviewed nine clinicians.

Of the patients surveyed, 95 percent felt they benefitted from exercise during treatment, but only three of the 20 patients recalled being instructed to exercise.

"Our results indicate that exercise is perceived as important to patients with cancer, both from a patient and physician perspective; however, physicians are reluctant to consistently include physical activity recommendations in their patient discussions," notes Dr. Smaradottir.

Gundersen oncologists were more inclined to refer patients to exercise physiologists – in part because they believed they didn't have the experience to determine the best exercises. Patients, on the other hand, preferred the advice come from their oncologists because of the relationship they had built, and the physicians were more familiar with their cases.

"Our findings highlight the value of examining both patient and provider attitudes and behavioral intentions. While we uncovered barriers to exercise recommendations, questions remain on how to bridge the gap between patient and provider preferences," Dr. Smaradottir adds.

Inspired by the findings from their initial research, Dr. Smaradottir and her team have started a prospective study looking at cancer patient health and satisfaction in a shared-care model of cancer treatment. The shared-care model will integrate exercise physiologists into oncology visits to help bridge the gap between patient and provider preferences.