Adherence to exercise: self-reported motivation and symptoms during cancer treatment should be considered in people with lung, head or neck cancer

<bold>Background:</bold> Exercise is beneficial during usual cancer treatment (UCT) (chemotherapy and radiotherapy). However, motivation and symptoms during UCT may interfere with adherence to exercise. We aimed to identify self-reported symptoms’ frequency and motivation to exercise during UCT in individuals with primary lung, head or neck cancer who underwent a home-based exercise training program (HETP) whilst undergoing UCT; and investigate the associations between symptoms/motivation with HETP adherence. <bold>Methods:</bold> Single-group interventional study. The HETP included aerobic (walk based) and resistance training (Therabands). Weekly assessments of symptoms were conducted using a questionnaire developed by the researchers. Exercise motivation was assessed with a 0 to 10 scale. Adherence was defined as the ratio between HETP sessions prescribed and completed for each participant. Symptom frequency was recorded as the number of weeks a symptom was present during UCT. Linear regression analysis was used to assess associations. Results: Twenty participants were included (63±7 yr; 18 males; 15 with head and neck cancer). The median duration of the HETP was 10 [8-14] weeks. The most frequent symptoms were fatigue (30%) and dysphagia (27%). Sadness was reported in 10% of weeks. The average motivation to exercise was 7±2. Adherence was 50±25%. Lower fatigue (R²=0.25), less sadness (R²=0.20) and higher motivation (R²=0.47) were associated with HETP adherence. <bold>Conclusion:</bold> Fatigue and dysphagia are frequently reported by people diagnosed with lung, head or neck cancer during UCT. Additionally, fatigue, sadness and motivation seem to influence adherence to HETP.