Cancer Survivors Becoming and Staying Physically Active: Challenges of Behavior Change

Despite the issuance of guidelines in several countries to encourage cancer survivors to adopt physical activity (PA), the proportion of survivors exercising at recommended levels is low. Cancer survivors face many barriers to becoming and staying physically active. There are numerous programs to help them become active; some of these programs are based on the theories of behavior change. We describe the results of reviews of these programs including the underlying constructs and techniques of behavior change. We also provide a status update on efforts to sustain PA: a smaller body of literature but one that merits further attention. Cancer survivors are not participating in exercise programs at various points in the cancer care continuum. To improve the uptake of PA, behavior change is required not only of the individual survivor but also of their families, peers and friends, and their healthcare providers. We describe the challenges of changing these levels of influence. Given the explosion of newer technologies, we describe the potential use of these technologies to overcome barriers to change and enhancing and expanding efforts to promote PA among cancer survivors. Finally, we propose future directions to make achievement of PA guidelines a reality for the growing number of cancer survivors worldwide.