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Walking could improve quality of life for those with advanced cancer

Posted on 16/02/2017

Walking could improve quality of life for those with advanced cancer A new study being published on the 16 February 2017 in the journal BMJ Open has found that walking can provide positive benefits for those with advanced cancer.

Funded by Dimbleby Cancer Care and led by researchers from the Florence Nightingale Faculty of Nursing & Midwifery, this study explored the impact of walking on quality of life and symptom severity in people with advanced cancer, including breast, prostate, gynaecological and haematological cancers. Life expectancy for people with recurrent or metastatic cancer is increasing, but this patient group is at considerable risk of experiencing psychological and physical health problems.

Despite growing evidence of significant health benefits, physical activity declines considerably during cancer treatment and remains low afterwards. Many of the activity-based interventions that are provided are supervised and require travel, limiting their acceptability to patients.

In contrast, walking is an adaptable, inexpensive, and accessible form of physical activity. In this study, the 12 week CanWalk intervention offered to patients was comprised of Macmillan’s Move More information booklet, and a short motivational interview which included the recommendation to walk for at least 30 minutes on alternate days, and attend a volunteer-led group walk weekly. The group walking activity ‘Walking for Health’ is provided by Macmillan Cancer Support and The Ramblers for people living with a long term condition.

Between April and November 2014, 42 people were recruited to the study from two London NHS Foundation Trusts. Overall, the group that received the walking intervention felt they benefitted in terms of physical, emotional, and psychological, social wellbeing and lifestyle changes. Wellbeing and lifestyle benefits, such as weight loss and improved fitness, as well as using pedometers, also motivated participants to increase the amount they walked. They spoke about how walking improved their overall quality of life, and helped them maintain a positive attitude towards their illness.

One of the participants commented: “The impact has been immense! It gave me the motivation to not only increase walking activity from minutes to 3-4 hours per week but also to reduce weight by altering diet, reducing sweets/sugars. Great boost to morale. No longer dwell on being terminal - I’m just on getting on with making life as enjoyable as possible, greatly helped by friends made on regular ‘walks for life’”.

Researchers found that the intervention was acceptable and well-tolerated, and demonstrated that exercise was popular and beneficial for patients. The intervention is also brief enough for health professionals to deliver in a clinical setting. In addition, off the shelf wearable technologies, such as activity trackers, could provide a more cost-effective approach to measuring outcomes.

 Dr Jo Armes, lead researcher and Senior Lecturer at the Florence Nightingale Faculty of Nursing & Midwifery, King’s College London said: “This study is a first step towards exploring how walking can help people living with advanced cancer. Walking is a free and accessible form of physical activity, and patients reported that it made a real difference to their quality of life. Further research is needed with a larger number of people to provide definitive evidence that walking improves both health outcomes and social and emotional wellbeing in this group of people.”

Dimbleby Cancer Care was set up in 1966 in memory of broadcaster Richard Dimbleby and is based at Guy’s Cancer Centre in Southwark, London. It provides practical and psychological support to people living with cancer and to their families and carers. The charity is also developing a website resource to help people find care and support services nearest to them.  

Paper reference: Tsianakas V, Harris J, Ream E, et al. CanWalk: a feasibility study with embedded randomised controlled trial pilot of a walking intervention for people with recurrent or metastatic cancer. BMJ Open 2017;7:e013719.

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