Telephone counseling plus clinician advice are proven effective in motivating cancer survivors to exercise

Telephone counseling, when combined with physician advice, can help cancer survivors become more physically active, which can improve quality of life and lessen the side effects of cancer treatment, according to new research. Further, integrating exercise into cancer follow-up care can improve recovery.

Women who received exercise advice from their surgeon or oncologist, followed by 3 months of telephone support, reported 30 more minutes of physical activity per week than patients who received exercise advice and follow-up calls about their general health.

These findings, which were published in Health Psychology (2013;32(6):616-626), reinforce the benefits of exercise in cancer recovery, including physical functioning. Physical activity has also been shown to reduce cancer-related fatigue and the risk for other chronic diseases, such as cardiovascular disease, obesity, and osteoporosis.

"Breast cancer patients are followed by their health care providers for a long time after treatment, which presents many opportunities for providers to share advice about physical activity and other healthy lifestyle changes," said lead author Bernardine M. Pinto, PhD, of The Miriam Hospital in Providence, Rhode Island.

"As survival rates improve, cancer is often viewed less as a death sentence and more as a chronic disease," said Pinto. "Cancer patients are interested in what they can do to improve their well-being, and getting advice from the care providers they see regularly can certainly help in adopting healthy lifestyles, including becoming physically active."

Pinto and colleagues conducted a randomized trial involving 192 breast cancer patients. In the study, oncologists and surgeons were asked to provide brief physical activity advice to patients who had completed treatment for Stage 0-IV breast cancer, including a recommendation of 30 minutes of moderate intensity exercise most days of the week and scheduling follow-up with research staff.

The 106 women who were randomized to the telephone counseling group received eight telephone calls over 12 weeks from counselors who monitored and supported their physical activity efforts. The remaining 86 participants assigned to the control group received the same number and frequency of telephone calls that focused on their general health. All participants were assessed at baseline and again at 3, 6, and 12 months.

Pinto and her team say patients in the telephone counseling group had considerably higher levels of physical activity and were almost twice as likely to meet national recommendations of 150 minutes per week of exercise 3 and 6 months later. Telephone counseling also significantly improved patients' motivational readiness throughout the 12-month study period, suggesting the potential for exercise promotion in cancer follow-up care.

"Our study clearly shows it's possible for motivated health care providers to provide brief advice to their patients during a follow-up visit," she said. "While we can't be sure physician advice alone would suffice, our results do suggest that health care provider advice will require supplementation, whether it's telephone counseling or some other mode of delivery, to support the adoption and maintenance of physical activity in cancer patients."
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