Aims
Exercise is an effective strategy to alleviate physical and psychosocial side-effects of chemotherapy and enhance clinical outcomes. However, many people with cancer struggle to engage in sufficient exercise due to barriers such as fear, limited access, and time constraints. The EX-FUSION trial addresses these challenges by providing supervised exercise during chemotherapy infusion (intra-infusion). This qualitative study explored the acceptability and experiences of EX-FUSION participants.
Methods
Adults aged <75 years receiving chemotherapy for stage I-III breast, colorectal or ovarian cancer were randomised to exercise or usual care. Participants in the EX-FUSION exercise group cycled for 20-minutes at moderate-intensity while receiving chemotherapy infusion in each of three cycles. All participants received exercise education. Following EX-FUSION, participants were invited to complete an optional semi-structured interview exploring their experiences of intra-infusion cycling (for those in the exercise group) and exercise education. Interviews were transcribed and analysed thematically.
Results
Fourteen participants, including seven from the exercise group, completed interviews (median age 59y; female: 86%; colorectal: 36%, ovarian: 50%, breast:14%). Three key themes were extracted: 1) perceptions of program structure; 2) global satisfaction; and 3) support beyond exercise. Intra-infusion cycling intensity and duration were suitable, with many wanting to exercise longer/harder. Cycling was familiar and enjoyable, although positioning in the chemotherapy chair (± ice mitts/booties) could be awkward. Both groups reported positive experiences with the program, appreciating the distraction it provided during infusion and empowering them to be active outside of treatment. The exercise physiologist was highly valued for exercise guidance and navigating participants to other services and support.
Conclusions
Our results highlight the acceptability of intra-infusion exercise. Participants in the EX-FUSION program found the experience enjoyable, particularly valuing the holistic support provided by the exercise physiologist. Intra-infusion exercise presents a promising new approach to integrating exercise into routine cancer care warranting further evaluation.