Physical activity counseling to cancer patients: How are patients addressed and who benefits most?

Objective This study examined cancer patients’ reporting on physicians’ physical activity (PA) counseling, its associations with patients’ PA, and comparisons of patients’ and physicians’ reports of the type(s) of PA counseling provided. Methods Patients with breast, colorectal, or prostate cancer (n = 1206) participated in a nationwide cross-sectional study. Cancer patients’ sociodemographic and treatment-related characteristics as well as self-reported PA levels (pre- and post-diagnosis) were assessed. PA counseling was queried according to the counseling steps of the 5As framework (Assess/Advise/Agree/Assist/Arrange). For a subsample (n = 135), matched patient-physician data were available. Results Patient-reported PA counseling was categorized into “no counseling” (indicated by 20.8% of participants), “basic counseling” (Assess and/or Advise; 58.8%), and “in-depth counseling” (Agree, Assist, and/or Arrange; 20.4%). “In-depth counseling” was associated with an increase in PA levels pre- to post-diagnosis. This relationship was enhanced for patients with metastases. There were low agreements between patients’ and physicians’ reporting of PA counseling steps. Conclusion In-depth PA counseling is rarely provided to cancer patients but seems to be required to affect PA levels. Patients often report receiving less intensive PA counseling than reported by their physician. Practice implications Physicians should be enabled to provide routine in-depth PA counseling to all patients with cancer.