Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2019

Exercise and androgen deprivation therapy: Current practice and future direction at a regional cancer centre.  (#387)

Hugh Elbourne 1 , Victoria O'Reilly 2 , Kheng Soo 3 , Mark Norden 4 , Anna Moran 4 , Christopher Steer 1
  1. University of New South Wales, Albury, NSW, Australia
  2. PCFA Nursing, St Leonards , NSW, Australia
  3. Eastern Health, Melbourne, VIC, Australia
  4. Albury Wodonga Health, University of New South Wales, Albury, NSW, Australia

Aims: To understand current supportive care practice, in particular exercise, for men with prostate cancer undergoing androgen deprivation therapy (ADT) at a regional cancer centre, and identify barriers and facilitators to exercise from clinician and patient perspectives.  

Design: Medical records from September 2017 to May 2018 were analysed for discussion of supportive care measures. Study of barriers and facilitators to exercise conducted via two self-reported paper-based surveys, for patients and clinicians.  

Results: 100 patients from medical and radiation oncology were analysed. Exercise was discussed with 16% of patients, and prescribed/recommended directly to 5%.  

Patient survey (n=47). 38.3% of patients achieved a high exercise level. Common barriers identified included fatigue (53.5%), cancer/treatment related weakness (48.9%) and stiffness (47.73%), other health problems (47.73%), and lack of motivation (47.73%). Fatigue, other health problems, and lack of motivation were inversely proportional to MET group (respectively, p = 0.043, 0.027, 0.012). 38.3% of patients reported an interest in a supervised exercise program.   

Clinician survey (n=20). 40% identified one or more guidelines, and only 55% correctly identified COSA guidelines, demonstrating poor clinician knowledge of exercise guidelines. Clinicians self-reported low knowledge on how to refer patients to a supervised exercise program (40%). Clinicians believe physiotherapists (95%) are most suited to prescription of exercise, and 70% believe that exercise counselling should be a part of provided care. Limited time (65%), and patient safety (65%) were the two most common barriers. Patient handouts (90%) and integration of exercise experts into the clinical team (85%) were viewed as the best facilitators to increase exercise uptake.  

Conclusions: Exercise is inadequately provided to men with prostate cancer undergoing ADT at a regional cancer centre.  Physical barriers and motivation are most concerning for patients. Clinicians report interest in further education, and better integration of exercise expertise into clinical care.