Physical Activity in Advanced Urological Cancers receiving Immune Check-Point Inhibitor Treatment – a qualitative study exploring patient perspectives and experiences.

Nicola Peat, Isla Veal, Mieke Van-Helmerijk, Sophia Karagiannis, Gareth D Jones, Netty Kinsella
Purpose:

The primary purpose of this study was to explore the perceptions and lived experiences of PA in a representative sample of cancer patients (urological cancer patients with advanced disease) undergoing ICI treatment.

Methods:

Individual semi-structured qualitative interviews were conducted with a purposive sample of adults with advanced urological cancer undergoing ICI treatment at a tertiary cancer centre, London, UK. A topic guide was used to support interviews. Interviews were audio-recorded and transcribed verbatim for analysis. Data were inductively analysed following Braun and Clarke’s six phases of Thematic Analysis.

Results:

Twelve in-person interviews were conducted lasting 34-69 minutes. Four main themes and eight sub-themes were identified. Main themes were: Having a purpose to participate in PA; Factors influencing participation in PA (barriers and facilitators); Lack of ameliorative support from healthcare professionals; and PA support – what is wanted. Overall, participants reported sub-optimal PA levels negatively influenced by deficient knowledge about PA and specific cancer/ICI treatment side-effects that included fatigue and pain. Facilitators of PA included positive valance, self-motivation and ameliorate support from healthcare professionals on the benefits and safety of PA.

Conclusion(s):

PA has the potential to be an effective strategy for managing cancer and its treatment side-effects during ICI treatment, however findings from this study indicate that it is not being utilised. Advanced cancer patients undergoing ICI treatment have distinct PA support needs related to consequences of their cancer and specific treatment effects. There is scope to improve access to PA interventions that encourage those with advanced cancer to maintain/increase PA levels when undergoing ICI treatment. Given the personalised needs of this patient group, referring patients to healthcare professionals with cancer exercise or rehabilitation expertise should be considered for prescription and support of tailored PA interventions.

Implications:

Future research should explore why PA support is not optimised during the ICI treatment pathway and identify the skills and resources needed to develop effective PA interventions to support participation in PA. Additionally, determining which ICI treatment specific side-effects could be targets for PA interventions and the differences in PA motivators could inform future research design and PA strategies.

Funding acknowledgements:
The lead researcher conducted this study as part of a masters in clinical research funded by NIHR Pre-doctoral fellowship award.
Keywords:
Novel
experiences
Qualitative
Primary topic:
Oncology, HIV and palliative care
Second topic:
Research methodology, knowledge translation and implementation science
Did this work require ethics approval?:
Yes
Name the institution and ethics committee that approved your work:
Health Research Authority Committee and East Midlands Research Ethics Committee
Provide the ethics approval number:
REC ID: 24/EM/0019
Has any of this material been/due to be published or presented at another national or international conference prior to the World Physiotherapy Congress 2025?:
No

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