Introduction
esophageal cancer, cancer, fatigue, Esophageal Cancer
CANCER, OESOPHAGEAL CANCER, ESOPHAGEAL CANCER
Patients who have been treated for cancer may experience cancer-related and treatment-related side effects impairing quality of life in the short and long term. Participation in (post-treatment) exercise programs has been proven to beneficially affect several health-related outcomes, such as fatigue, physical fitness, and quality of life [Like any medical intervention, uptake of the exercise program (adherence) by the patient is important to achieve optimal effects. For exercise programs, it is therefore important that participating patients are present at the prescribed exercise sessions (attendance). Also, benefits of an exercise program may be largest if patients fulfill all components of the exercise program according to the exercise protocol (compliance or relative dose intensity (RDI)). Attendance and RDI are the two components that are united in the broader concept “adherence” [In the Physical ExeRcise Following Esophageal Cancer Treatment (PERFECT) trial, we randomized esophageal cancer survivors between usual care and a 12-week post-treatment exercise program. The exercise program consisted of both aerobic and resistance exercises, performed at moderate-to-high intensity and individualized to the patients’ fitness level before start of the program [When applying exercise programs in regular clinical cancer care, adherence rates ideally should be comparably high as found in this trial. An understanding of which elements help or hamper patients to complete the exercise program as prescribed can support in designing exercise programs for clinical practice. Information on barriers for attending exercise sessions or not fulfilling specific components of the exercise program can help to improve the program and decrease dropout rates, while information on facilitators can indicate which aspects of the program should be retained or even extended for optimal adherence. For the current study, we performed semi-structured telephone interviews with patients participating in the PERFECT exercise program, to identify facilitators and barriers to exercise adherence.