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Better Clinician Support Needed to Improve Exercise Counseling for Cancer Survivors

Health care practitioners (HCPs) need additional education and practical support to provide cancer survivors with exercise-related guidance, resources, and referrals, according to research published in Supportive Care in Cancer.

To investigate HCPs’ knowledge, beliefs, and practices regarding exercise counseling and referral of cancer survivors to exercise programs, researchers conducted a cross-sectional online survey.

The survey was completed by 375 participants between February 2020 and February 2021. Of those, 42% were medical practitioners, 28% were nurses, 29% were nonexercise allied health practitioners, and 14% were exercise specialists.

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Many participants were already aware of some knowledge gaps. “Between 35% and 50% of participants self-reported low levels of knowledge with respect to when, how, and which cancer survivors to refer to exercise programs or exercise specialists, and how to counsel based on exercise guidelines,” the researchers reported. “More than 90% of exercise specialists self-reported good knowledge in all domains.”

Other findings included:

  • More than half of medical practitioners reported good knowledge about which cancer survivors could be referred to a supervised program and how to refer them.
  • Most respondents said exercise should be part of routine care, and 68% reported that exercise counseling is a routine component of the care they provide.
  • Participants who met guidelines for physical activity themselves were more likely to discuss the role of exercise in symptom management or provide specific exercise advice to patients.
  • Almost all of the participants (94%) favored exercise specialists as the best possible HCP to discuss exercise with cancer survivors.

The researchers also identified barriers to exercise counseling. The respondents who are not exercise professionals cited barriers such as safety concerns, time constraints, and a lack of knowledge about how to screen a survivor to gauge suitability for exercise.

“Given that knowledge is hypothesized to influence behavior change and was a key predictor of participants’ current practices, increasing educational and engagement opportunities for HCPs may support the implementation of exercise guidelines in their routine practice,” the researchers concluded.

Study limitations included a lack of diversity, as the survey was English-only, and the sample size was weighted toward female participants from high-income countries. “Given these limitations, the results can only serve as explorative in nature and may not be generalizable,” the researchers wrote.

Disclosures: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.


Ramsey I, Chan A, Charalambous A, et al. Exercise counselling and referral in cancer care: an international scoping survey of health care practitioners’ knowledge, practices, barriers, and facilitators. Support Care Cancer. Published online September 29, 2022. doi:10.1007/s00520-022-07342-6

This article originally appeared on Oncology Nurse Advisor

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