Aims: The benefits of exercise for managing many side effects of androgen deprivation therapy (ADT) are well-established. However, most men receiving ADT for prostate cancer do not achieve recommended levels of exercise. The aims of this mixed-methods study were to describe in men on ADT: i) exercise behaviour over 12 months; and, ii) barriers and facilitators to exercise engagement.
Methods: Men receiving ADT for prostate cancer were recruited from the Radiation Oncology Clinic, Northern Sydney Cancer Centre. Men were offered referral to a community exercise program at enrolment and followed up three, six and 12 months later. Motivational readiness (Motivational Readiness for Exercise) and physical activity levels (modified Godin Leisure-Time Exercise Questionnaire) were captured quantitatively. Semi-structured interviews explored exercise behaviour. Interviews were transcribed and analysed thematically. Here we report longitudinal qualitative results contrasting levels of motivational readiness at baseline.
Results: Sixteen men (median age 72y, range 58-84y) participated in 29 interviews. While 52% reported high levels of motivational readiness for exercise at baseline, only 22% met exercise recommendations. There was with little change in motivation or exercise engagement over time. Four key themes were identified related to exercise engagement: 1) education; 2) physical function; 3) physical activity mindset; and 4) external environment. Lack of exercise education presented as a barrier to exercise engagement, with many men unclear about the importance of exercise, how to exercise (particularly resistance training) and availability of supportive exercise resources.
Conclusions: Exercise behaviour in men receiving ADT was relatively consistent over 12 months, with few men achieving recommended levels of exercise. Most men had little or no experience or knowledge of resistance or structured exercise and did not value these forms of exercise. Comprehensive exercise education may be a potential strategy to shift perceptions and facilitate engagement with exercise.