Andrea L. Cheville, M.D., from the Mayo Clinic in Rochester, Minn., and colleagues conducted semistructured interviews with 20 adults with stage IIIB or IV non-small-cell lung cancer. The participants' level of activity; influence of their symptoms on activities; perceived barriers and facilitators for exercise; and exercise-related instruction from professional caregivers were assessed.

The researchers found that usual daily activities were overwhelmingly reported as the source of "exercise." Symptoms, specifically treatment-related symptoms, discouraged patients from participating in exercise, with younger women experiencing a significant concern regarding fear of harm. Participants recognized that exercise was important for physical and mental well-being but did not appreciate its role in mitigating symptoms. Current exercise behaviors were modulated based on weather, recalled levels of premorbid fitness, and exercise participation. None of the participants reported having received more specific encouragement other than to "stay active," with a lack of direction taken as an approval of their current exercise status. Participants preferred to receive guidelines from their oncologists and seemed less receptive to advice from ancillary health professionals.

"Effective use of exercise and activity modification to ameliorate cancer-related symptoms appears to require a linkage to a patient's usual and past activities, proactive negotiation of potential barriers, education regarding symptoms and exercise, and the positive support of their oncologist," the authors write.

Abstract
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