Integrating supervised physical activity into breast cancer survivorship care.

Abstract

e24050 Background: Although the benefits of physical activity are well established, participation rates among cancer survivors remain low. Barriers include the lack of structured survivorship care plans, limited access to exercise programs, geographic constraints, and financial limitations. To address these challenges, a community-based integrative oncology program has been implemented within the Italian National Health System for two years, combining tailored lifestyle counseling with adapted physical activity (APA) to promote healthy behaviors among cancer survivors. Methods: A prospective, observational study evaluated the feasibility. During scheduled oncology follow-up, cancer survivors with lifestyle-related risk factors were clinically referred to the program. Ninety-seven participants, mainly breast cancer women, received a one-hour individualized lifestyle medicine consultation followed by supervised group-based adapted physical activity (APA) sessions twice weekly for 8–12 weeks. Each 60-minute session included mobility, resistance training, core stability, and balance exercises, supervised by a kinesiologist and orthopedic specialist. Functional outcomes were assessed pre- and post-intervention using the six-minute walk distance (6MWD), five-times sit-to-stand test (5xSTS), handgrip strength (HGT), and single-leg stance (SLS). Adherence, safety, and patient satisfaction were recorded. Physical activity participation was reassessed at six-month follow-up. Results: At baseline, participants’ fitness levels were significantly lower than those of an age-matched healthy reference group (48-65 years). Adherence, defined as the proportion of training sessions attended out of those prescribed, was 72.5 ± 18.5%, with a total drop-out rate of 19%. After the program, the 6MWD increased by approximately 80 m, and SLS errors decreased by 1.4 compared to baseline ( p < 0.001 ). HGT improved by 1.40 kg, and 5xSTS time decreased by 1.7 seconds ( p < 0.05 ). No adverse events were reported, and 88% of participants rated the program as excellent. At baseline, only 30% of participants were physically active. At six-month follow-up, 65% continued to engage in regular physical activity with a kinesiologist or in walking groups. Among the remaining participants, 31% discontinued due to health-related issues unrelated to cancer, and 4% stopped due to lack of time. Conclusions: Our community-based oncology program educates participants on integrating physical activity into survivorship care. Accessibility, professional supervision, group support, and clinical endorsement are key drivers of engagement. These findings highlight both the challenges and opportunities in implementing effective survivorship exercise programs and may inform future initiatives.