Speaker
Description
Introduction: Although exercise is increasingly recognized as safe and beneficial for patients with bone metastases, clinicians often remain hesitant to recommend it. However, the reasons behind this reluctance are not fully understood. This study explored healthcare professionals’ attitudes, knowledge, and perceived barriers regarding exercise in patients with bone metastases.
Methods: An online survey was distributed across Italy through a professional mailing list. The questionnaire, developed with oncologists, radiotherapists, and exercise professionals, collected information on: (i) demographics and professional background; (ii) current practices in assessing, advising, and referring patients to exercise; (iii) clinical factors influencing recommendation; and (iv) barriers and facilitators. Descriptive statistics were used.
Results: Eighty-nine participants completed the survey, mostly oncologists (72%), primarily treating thoracic and breast cancers. Assessment of patients’ exercise was limited, performed sometimes (29%) or rarely (25%). Although 65% reported advising patients to increase activity levels and 57% reinforced its importance, only 24% referred patients to structured exercise services. Clinicians generally agreed that exercise improves psychological well-being and bone health, yet 47% were unsure whether exercise could worsen bone pain, compromise safety (46%), or increase the risk of skeletal-related events (43%). Several clinical factors discouraged recommendation, including osteolytic lesions, cervical or thoracic vertebral involvement, complicated bone disease, previous SREs, and pain at metastatic sites. The most frequently reported barrier in recommendations was the lack of dedicated exercise programs (70%), followed by insufficient training in assessing suitability. Conversely, educational sessions for healthcare teams (74%) and the integration of exercise specialists into clinical pathways (71%) were viewed as key facilitators.
Conclusions: Clinicians recognize the value of exercise but remain uncertain about its safety in complex metastatic scenarios. Expanding dedicated exercise programs, enhancing multidisciplinary collaboration, and providing targeted education may represent crucial steps to increase patients' exercise levels.
Keywords
Bone metastases; Clinicians; Exercise; Barriers;
| Abstract submitters declaration | yes |
|---|---|
| Conflict of Interest & Ethical Approval | yes |
