Perceptions of masculinity and body image in men with prostate cancer: the role of exercise

Reconsidering tools for measuring gender dimensions in biomedical research

Sex and gender play important roles in contributing to disease and health outcomes and represent essential, but often overlooked, measures in biomedical research. The context-specific, multifaceted, and relational nature of gender norms, roles, and relations (i.e., gender dimensions) make their incorporation into biomedical research challenging. Gender scores-measures of gender dimensions-can help researchers incorporate gender into quantitative methodologies. These measures enable researchers to quantify the gendered dimensions of interest using data collected from survey respondents. To highlight the complexities of using gender scores within biomedical research, we used the application of the Bem Sex Role Inventory (BSRI) scale, a commonly used gender score, to explore gender differences in adverse events to the influenza vaccine among older adults (75+). Within this paper, we focus on the findings from our longitudinal gender score data collected over three influenza seasons (2019-20, 2020-21, and 2021-22), irrespective of adverse event data, to provide commentary on the reliability of gender scores, such as the BSRI, and the complexities of their application. Of the 162 total study participants included within the study, 69 were enrolled in all three consecutive seasons and 35 participants were enrolled in two consecutive seasons. The majority of participants had a different gender score in at least one of the years, demonstrating the nuances and fluidity of gender identity. Interpretations of BSRI data (or other gender score data) when measured against outcome data must, therefore, be time and context specific, as results are unlikely to be replicated across years.

Relationship between social support, self-esteem and sense of masculinity among geriatric Patients with Prostatic Cancer

BACKGROUND

Most geriatric patients with prostate cancer experience not only external discomfort but also negative psychological consequences such as reduced feelings of masculinity and diminished self-esteem. Social support is a protective factor for dealing with and adapting to these stressors, which enhances quality of life.

AIM

To identify the relationship between social support, self-esteem, and sense of masculinity among geriatric patients with PC.

METHOD

The study is a cross-sectional survey adopting a descriptive correlational design. A convenience sample of one hundred ten (110) geriatric patients diagnosed with PC attending the oncology and urology outpatient clinics of Damanhur Oncology Center in El-Beharia Governorate, Egypt. Four tools were used: subjects' basic information, The Personal Resources Questionnaire (PRQ-2000), the Rosenberg Self-esteem Scale (RSE), and The Masculine Self-esteem scale (MSES).

RESULTS

74.6 % of the studied geriatric patients had high levels of social support, 86.4 % had moderate levels of self-esteem, and 55.4 % had low masculine self-esteem. Also, the relationship was a statistically significant between social support and self-esteem (p = .002), between social support and sense of masculinity (p = .038), and between self-esteem and sense of masculinity (p = .029).

CONCLUSION

social Support and self-esteem were significant predictors of high sense of masculinity with social support positively influencing and self-esteem negatively influencing the sense of masculinity.

Inclusivity in prostate cancer and exercise research: a systematic review

BACKGROUND

Prostate cancer (PCa) is the most prevalent type of cancer in men in the UK. Exercise has been shown to improve the health and quality of life of PCa patients. Exercise should be easily accessible to men with PCa regardless of socioeconomic group or ethnicity. There is a need to better understand whether the current evidence base for exercise interventions is representative and inclusive of racial and ethnic minority men with PCa.

METHODS

A systematic review of the literature was conducted according to PRISMA guidelines and prospectively registered via Prospero (ID: CRD42022384373). The MEDLINE Ovid, Cochrane Library and PubMed databases were searched from inception to December 2022. The search strategy keywords and MeSH terms used included the following: (1) exercise, (2) training, (3) prostate cancer, (4) ethnic and (5) diversity.

RESULTS

A total of 778 records were retrieved from database searches, of which 15 records were duplicates. A further 649 were eliminated following the screening of titles and abstracts. After full-text screening of 186 articles, 28 manuscripts were included for review.

CONCLUSION

This systematic review highlights that there is high heterogeneity in the reporting of participants' ethnicity and there are low numbers of ethnic minority men included in PCa and exercise studies in the UK. Further work is required to understand why representation is lacking within PCa exercise trials in the UK and strategies are needed to achieve representation from all ethnic groups.

IMPLICATIONS FOR CANCER SURVIVORS

Improved representation and reporting of ethnicity in exercise trials is vital to ensure the results are applicable to all patients.

Understanding the Experiences of Physical Activity, Body Image, and Quality of Life in Young Adult Males Living with and beyond Cancer

For young adults (YAs), a cancer diagnosis and subsequent treatments may result in physical changes that can negatively impact body image (BI) and health-related quality of life (HRQL). Physical activity (PA) is an evidence-based tool found to impact both BI and HRQL. However, most research has focused on the perspectives of older adults with breast or prostate cancer. No research has explored the experiences of PA, BI, and HRQL in YA males affected by cancer. A qualitative study was designed for YA males diagnosed with cancer between the ages of 20 and 39 years. Eligible participants were recruited through pre-existing exercise oncology studies, support organizations, and social media. Semi-structured interviews were conducted to understand participants' experiences of PA, BI, and HRQL. All interviews were transcribed verbatim and analyzed using interpretive description. The participants were YA males (n = 7) with a mean age of 32.7 ± 4.0 years. Themes included a loss of identity due to cancer, building autonomy and identity using PA, and the "should" behind BI. PA for YA males living with and beyond cancer may support them in rebuilding their identity and BI. The development of exercise oncology resources for YA males may consider addressing BI through education or exercise prescription programs, with the goal of enhancing HRQL.

Body image in patients with prostate cancer undergoing treatment with hormone therapy: Observational study using both a cross-sectional and longitudinal design

This study aims to examine changes in body image (BI) over time and factors related to BI among patients with prostate cancer who receive hormone therapy (HT). A cross-sectional design and longitudinal design were utilized. Patients with prostate cancer who received HT were recruited from the urology outpatient departments in two hospitals in Taiwan between August 2017 and December 2020. Cross-sectional data were collected from 177 patients who had started HT for prostate cancer. Longitudinal data were collected from 34 newly diagnosed patients before receiving HT and at 1, 3, 6, and 12 months after HT. The variables measured included hormonal symptoms and distress, self-efficacy, and BI. The results showed that BI dissatisfaction ranged from 6.1% to 17.2%. Hormonal symptoms and distress (e.g. lack of vitality) were correlated with BI dissatisfaction. Education on the side effects of HT and coping strategies can be provided to patients to prevent BI dissatisfaction.

Men's Achilles' heel: prostate cancer and the reconstruction of masculinity

The aim of this study was to investigate how Swedish men diagnosed with prostate cancer understand the effects of their treatment in relation to sexual health and masculinity. Utilising a phenomenological and sociologically informed approach, the study involved interviews with 21 Swedish men who experienced problems following treatment. The results showed that participants' initial response post-treatment, involved the development of new bodily understandings and socially informed strategies to handle incontinence and sexual dysfunction. Due to impotence and the loss of ejaculatory ability following treatments such as surgery, participants re-articulated the meaning of intimacy, as well as their understanding of masculinity and themselves as ageing men. Unlike in previous research, such a re-articulation of masculinity and sexual health is understood as taking place within rather than in opposition to hegemonic masculinity.

The intersection of biological sex and gender in adverse events following seasonal influenza vaccination in older adults

BACKGROUND

Women/females report more adverse events (AE) following immunization than men/males for many vaccines, including the influenza and COVID-19 vaccines. This discrepancy is often dismissed as a reporting bias, yet the relative contributions of biological sex and gender are poorly understood. We investigated the roles of sex and gender in the rate of AE following administration of the high-dose seasonal influenza vaccine to older adults (≥ 75 years) using an AE questionnaire administered 5-8 days post-vaccination. Participant sex (male or female) was determined by self-report and a gender score questionnaire was used to assign participants to one of four gender categories (feminine, masculine, androgynous, or undifferentiated). Sex steroid hormones and inflammatory cytokines were measured in plasma samples collected prior to vaccination to generate hypotheses as to the biological mechanism underpinning the AE reported.

RESULTS

A total of 423 vaccines were administered to 173 participants over four influenza seasons (2019-22) and gender data were available for 339 of these vaccinations (2020-22). At least one AE was reported following 105 vaccinations (25%), by 23 males and 82 females. The majority of AE occurred at the site of injection, were mild, and transient. The odds of experiencing an AE were 3-fold greater in females than males and decreased with age to a greater extent in females than males. The effects of gender, however, were not statistically significant, supporting a central role of biological sex in the occurrence of AE. In males, estradiol was significantly associated with IL-6 and with the probability of experiencing an AE. Both associations were absent in females, suggesting a sex-specific effect of estradiol on the occurrence of AE that supports the finding of a biological sex difference.

CONCLUSIONS

These data support a larger role for biological sex than for gender in the occurrence of AE following influenza vaccination in older adults and provide an initial investigation of hormonal mechanisms that may mediate this sex difference. This study highlights the complexities of measuring gender and the importance of assessing AE separately for males and females to better understand how vaccination strategies can be tailored to different subsets of the population.

The intersection of biological sex and gender in adverse events following seasonal influenza vaccination in older adults

Background Women/females report more adverse events (AE) following immunization than men/males for many vaccines, including the influenza and COVID-19 vaccines. This discrepancy is often dismissed as a reporting bias, yet the relative contributions of biological sex and gender are poorly understood. We investigated the roles of sex and gender in the rate of AE following administration of the high-dose seasonal influenza vaccine to older adults (≥ 75 years) using an AE questionnaire administered 5-8 days post-vaccination. Participant sex (male or female) was determined by self-report and a gender score questionnaire was used to assign participants to one of four gender categories (feminine, masculine, androgynous, or undifferentiated). Sex steroid hormones and inflammatory cytokines were measured in plasma samples collected prior to vaccination to elucidate a possible biological mechanism for the AE reported. Results A total of 423 vaccines were administered to 173 participants over four influenza seasons (2019-22) and gender data were available for 339 of these vaccinations (2020-22). At least one AE was reported following 105 vaccinations (25%), by 23 males and 82 females. The majority of AE occurred at the site of injection, were mild, and transient. The odds of experiencing an AE were 3-fold greater in females than males and decreased with age to a greater extent in females than males. The effects of gender, however, were not statistically significant, supporting a central role of biological sex in the occurrence of AE. In males, estradiol was significantly associated with IL-6 and with the probability of experiencing an AE. Both associations were absent in females, suggesting a sex-specific effect of estradiol on the occurrence of AE that supports the finding of a biological sex difference. Conclusions These data support a larger role for biological sex than for gender in the occurrence of AE following influenza vaccination in older adults and provide an initial investigation of hormonal mechanisms that may mediate this sex difference. This study highlights the complexities of measuring gender and the importance of assessing AE separately for males and females to better understand how vaccination strategies can be tailored to different subsets of the population.

The Operationalisation of Sex and Gender in Quantitative Health-Related Research: A Scoping Review

Current trends in quantitative health research have highlighted the inadequacy of the usual operationalisation of sex and gender, resulting in a growing demand for more nuanced options. This scoping review provides an overview of recent instruments for the operationalisation of sex and gender in health-related research beyond a concept of mutually exclusive binary categories as male or masculine vs. female or feminine. Our search in three databases (Medline, Scopus and Web of Science) returned 9935 matches, of which 170 were included. From these, we identified 77 different instruments. The number and variety of instruments measuring sex and/or gender in quantitative health-related research increased over time. Most of these instruments were developed with a US-American student population. The majority of instruments focused on the assessment of gender based on a binary understanding, while sex or combinations of sex and gender were less frequently measured. Different populations may require the application of different instruments, and various research questions may ask for different dimensions of sex and gender to be studied. Despite the clear interest in the development of novel sex and/or gender instruments, future research needs to focus on new ways of operationalisation that account for their variability and multiple dimensions.

Social Support Mediates the Relationship between Body Image Distress and Depressive Symptoms in Prostate Cancer Patients

Treatments for prostate cancer (PCa), the second most common cancer in men, may affect the body image (BI) of patients, increasing the risk of negative mental health outcomes. However, an enabling social support network may be a protective factor against the effects of BI distress on health. Therefore, the present study examined the mediating role of social support in the relationship between BI distress and depressive symptoms. Data were retrospectively collected from 197 PCa patients aged from 48 to 79 years (M = 67.19; SD = 6.83). The statistical package for the social sciences with PROCESS Macro was used to assess the direct and mediating effects with bias-corrected bootstrapping (10,000 samples). Results showed that BI distress was positively associated with depressive symptoms and that social support partially mediated this relationship. Moreover, among the different sources of social support, only friend support significantly mediated the association between BI distress and depressive symptoms. This study sheds light on the crucial role of social support as a dimension that can promote health in PCa patients.

Cancer Survivorship: Religion in Meaning Making and Coping Among a Group of Black Prostate Cancer Patients in South Africa

The purpose of the study was to explore the role of religion in meaning making and coping among a group of black patients receiving some form of prostate cancer treatment at a public hospital in Limpopo Province, South Africa. A sample of 20 prostate cancer survivors, with ages ranging from 67 to 85 years (mean_age = 76yrs; SD = 5.3) selected through purposive sampling. Data were collected through in-depth, semi-structured individual interviews and analysed using interpretative phenomenological analysis (IPA). The findings demonstrated that religion is an important factor in meaning making and coping by prostate cancer survivors. The findings suggest that healthcare practitioners need to pay close attention to the meanings that cancer patients assign to their illness to provide the appropriate care and support.

Taking Advantage of the Teachable Moment at Initial Diagnosis of Prostate Cancer-Results of a Pilot Randomized Controlled Trial of Supervised Exercise Training

BACKGROUND

Increased physical activity (PA) levels are associated with improved prostate cancer (PCa) outcomes. Sustainable PA has been linked to improved health-related quality of life (QoL) in cancer patients. The time of diagnosis of PCa may offer a critical time point when patients might be more likely to consider lifestyle changes. This, in turn, may contribute to sustainable PA and its likely benefits.

OBJECTIVE

The aims of this study were to determine if a structured PA intervention introduced at the time of diagnosis can (1) lead to sustainable PA and (2) help improve psychosocial and QoL outcomes as compared with usual PA.

INTERVENTIONS/METHODS

This was a pilot randomized controlled trial enrolling patients with intermediate-risk PCa into either arm A (supervised 8- to 12-week physical exercise program; n = 10) or control arm B (usual PA; n = 10). Primary outcome was PA at 6 months. Secondary outcomes were QoL, psychological well-being, physical fitness, and functional outcomes postintervention. Change over time was compared using a nonparametric Wilcoxon test.

RESULTS

Demographic variables were the same between arms. Comparing parameters at the start and 6 months post-radical prostatectomy, PA significantly improved in arm A (self-reported Godin score 24.7 vs 42.8 units, P < .01, objective number of chair stands [14-19, P < .01]), but not in arm B. There were no significant differences between arms in QoL and psychosocial outcomes.

CONCLUSIONS

A preoperative supervised exercise training program increases long-term PA.

IMPLICATIONS FOR PRACTICE

Future trials should evaluate PA sustainability beyond 6 months and if this leads to improved psychosocial and QoL outcomes.

Impact of lifestyle in prostate cancer patients. What should we do?

Objective:

This review aimed to analyze interventions raised within primary and tertiary prevention concerning the disease's incidence, progression, and recurrence of Prostate Cancer (PCa). Priority was given to the multidisciplinary approach of PCa patients with an emphasis on modifiable risk factors.

Materials and Methods:

We conducted a comprehensive literature review in the following databases: Embase, Central, and Medline. We included the most recent evidence assessing cohort studies, case-control studies, clinical trials, and systematic reviews published in the last five years. We only included studies in adults and in vitro or cell culture studies. The review was limited to English and Spanish articles.

Results:

Preventive interventions at all levels are the cornerstone of adherence to disease treatment and progression avoidance. The relationship in terms of healthy lifestyles is related to greater survival. The risk of developing cancer is associated to different eating habits, determined by geographic variations, possibly related to different genetic susceptibilities.

Discussion:

PCa is the second most common cancer in men, representing a leading cause of death among men in Latin America. Prevention strategies and healthy lifestyles are associated with higher survival rates in PCa patients. Also, screening for anxiety and the presence of symptoms related to mood disorders is essential in the patient's follow-up concerning their perception of the condition.

Barriers and facilitators related to undertaking physical activities among men with prostate cancer: a scoping review

BACKGROUND

Prostate cancer (PC) and its treatments lead to significant acute, chronic, or latent adverse effects that result in declines in patients' physical functions, quality of life and reduced sense of masculinities. Robust evidence shows that physical activity (PA) can improve many health outcomes in men with PC; however, less is known about the facilitators, preferences, and barriers to PA engagement in this population. The purpose of this scoping review is to document the nature and extent of literature related to these aspects of PA participation among men with PC.

METHODS

We conducted a scoping review of PA among men with PC. Databases searched included Medline, CINAHL, Embase, Rehabilitation & Sports Medicine Source, and SportDiscus from inception to June 30, 2020. Multiple reviewers were used in all screening and data abstractions.

RESULTS

The search yielded 2788 individual citations after duplicates were removed. Following title and abstract screening, 129 underwent full-text review, and 46 articles were included. Quantitative data related to our research question showed that structured group exercise was the most commonly reported facilitator/preference among men with PC, whereas treatment-related effects and lack of time are the most common barriers. In terms of qualitative data, the most prominent theme noted related to masculinities and gender-specific needs within the context of having PC.

CONCLUSION

Men with PC have unique facilitators and barriers concerning PA. More work is needed from the research and clinical practice perspectives to enable this population to engage and remain in regular PA.

Coping strategies in active and inactive men with prostate cancer: a qualitative study

PURPOSE

Prostate cancer can result in a shift in the way men perceive their masculinity. Despite the interest in exercise as a treatment strategy to address masculinity concerns, there is insufficient information about how perceptions may differ in active and inactive men. The aim of this study was to explore how exercise might influence self-perceptions of masculinity in men across the exercise continuum (from active to inactive) and in men receiving different forms of treatment for their prostate cancer, including androgen deprivation therapy.

METHODS

Individual, semi-structured interviews were conducted with 15 men. Ten men met aerobic and/or resistance guidelines and were considered active, while five men, considered inactive, reached neither guideline. This study used a grounded theory approach to data analysis, examining masculinity issues in active men and compared them to inactive men.

RESULTS

Redefining masculinity emerged as an overarching theme. Subthemes were the various coping strategies men used to redefining masculinity and directly related to their exercise habits. Coping subthemes included re-establishing control, tapping into competition, remaining socially connected, rationalization, and acceptance.

CONCLUSIONS

In the active men, dominant coping strategies achieved from exercise included control through active participation, acceptance, competition, and leadership. In inactive men, control was observed with knowledge-seeking behaviors, rationalization, and acceptance.

IMPLICATIONS FOR CANCER SURVIVORS

A tailored approach to exercise counseling based upon specific masculine traits and motivations could lead to improved exercise engagement.

Body image in men with prostate or laryngeal cancer and their female partners

Objectives: The study examines body image of male cancer patients and their female partners as well as factors influencing body image. Methods: N = 73 heterosexual couples in which the male partner was diagnosed with prostate (PC; n = 52) or laryngeal cancer (LC; n = 21) completed questionnaires on body image acceptance (Self Image Scale), relationship satisfaction (Quality of Marriage Questionnaire), and cancer-related distress (Questionnaire on Stress in Cancer Patients). The body image was assessed from two perspectives: self-acceptance (which measures a person's satisfaction or acceptance of the body) and partner-acceptance (which assesses a person's perception of the partners' appraisals of the body). Results: No differences occurred in body image acceptance between men with PC or LC. Patients with PC rated the perceived partner-acceptance lower than did their female partners. In couples with LC, women rated the self-acceptance of their partners higher than did the patients themselves. Multiple regression analysis revealed that for survivors of PC, cancer-related distress, relationship satisfaction and partner-acceptance emerged as significant predictors of self-acceptance. The only significant predictor of partner-acceptance was men's self-acceptance. Conclusions: The dissatisfaction with physical appearance is found in PK and LK patients and seems to persist for a long time. Impairment of patients' body image should be identified and addressed to prevent the negative effects on psychosocial stress for patients and relationship satisfaction.

Motion and Gender-Typing Features Interact in the Perception of Human Bodies

The human body conveys socially relevant information, including a person's gender. Several studies have shown that both shape and motion inform gender judgments of bodies. However, while body shape seems to influence more the judgment of female bodies, body motion seems to play a major role in the judgments of male bodies. Yet, the interdependence of morphologic and dynamic cues in shaping gender judgment and attractiveness evaluation in body perception is still unclear. In two experiments, we investigated how variations of implied motion and shape interact in perceptual and affective judgments of female and male bodies. In Experiment 1, participants were asked to provide ratings for masculinity and femininity of virtual renderings of human bodies with variable gender-typing features and implied motion. We found evidence of a tendency to perceive bodies in static poses as more feminine and bodies in dynamic poses as more masculine. In Experiment 2, participants rated the same pictures for dynamism and pleasantness. We found that male bodies were judged more dynamic than female bodies with the same pose. Also, female bodies were liked more in static than in dynamic poses. A mediation analysis allowed us to further shed light on the relationship between gender-typing features and motion, suggesting that the less is the movement conveyed by a female body, the greater is an observer's sensitivity to its femininity, and this leads to a more positive evaluation of its pleasantness. Our findings hint to an association between stillness and femininity in body perception, which can stem from either the evolutionary meaning of sexual selection and/or the influence of cultural norms.

Does Physical Activity Regulate Prostate Carcinogenesis and Prostate Cancer Outcomes? A Narrative Review

Background: Prostate cancer (PCa) represents a common disease in men aged >65 years. The role of physical activity (PA) in patients at risk or diagnosed with PCa represents an evolving issue. We aimed to summarize available evidences about the impact of PA on the pathophysiology and clinical outcomes of PCa. Methods: We performed a narrative review. Evidences about the role of PA in elderly patients in terms of PCa biology, epidemiology, oncological and functional outcomes, as well as in terms of impact on the outcomes of androgen deprivation therapy (ADT) were summarized. Results: Potential pathophysiological pathways hypothesized to explain the benefits of PA in terms of prostate carcinogenesis include circulating levels of Insulin-like growth factor-1 (IGF-1), oxidative stress, systemic inflammation, sex hormones, and myokines. Clinically, emerging evidences support the hypothesis that PA is associated with decreased PCa risk, improved PCa-related survival, improved functional outcomes, and reduced ADT-related adverse events.

Transitory masculinities in the context of being sick with prostate cancer

Objective:

to interpret the meanings attributed by men with prostate cancer to the experience regarding their bodies and masculinities during illness.

Method:

ethnographic research with 17 men, guided by the narrative method and theoretical framework of medical anthropology and masculinities. The information was collected through recorded interviews, direct observation and field diary records, which were analyzed by inductive thematic analysis.

Results:

men undergo body and identity transformations when they get sick with prostate cancer, transiting through multiple masculinities, resigning their actions, and occupying subordinate positions in relation to other healthy bodies, which are marginalized in their social relationships and allied with regard to establishing their affective relationships.

Conclusion:

this evidence enhances and deepens the knowledge disclosed in the literature and contributes to the strengthening of nursing care actions when dealing with the sick.

Body image issues and attitudes towards exercise amongst men undergoing androgen deprivation therapy (ADT) following diagnosis of prostate cancer

BACKGROUND

Androgen deprivation therapy (ADT) is an established treatment for prostate cancer (PCa), but its side-effects can affect body appearance and functioning. However, research into the impact of ADT on body image is limited. Exercise can help patients to counterbalance some side-effects, potentially improving body image too. However, adherence to exercise recommendations is low. Therefore, we explored body image after ADT and attitudes towards exercise.

METHODS

Twenty two semi-structured interviews were conducted with PCa patients receiving ADT (M_age = 67.9 years old, SD = 9.99).

RESULTS

Participants expressed appearance dissatisfaction focusing on body feminization. Participants exercised to counterbalance ADT side-effects and improve mood. Exercise also helped them to re-establish a sense of control over their body and experience a sense of achievement. However, some men described being worried that their appearance and physical performance would be judged by others, so they often exercised alone or gave up exercise. Time management and fatigue were also identified as exercise barriers.

CONCLUSION

These findings highlight the need to further investigate body image concerns and exercise barriers in PCa patients undergoing ADT. These results could also inform support groups and health care professionals on the topic. However, further research should explore the most effective and acceptable ways to provide support to PCa patients on body image issues.

Qualitative Evaluation of a Community-Based Physical Activity and Yoga Program for Men Living With Prostate Cancer: Survivor Perspectives

Purpose

Physical activity (PA) programs for prostate cancer survivors have positive effects on many aspects of health-related quality of life. Translating this research into sustainable community-based settings is necessary to ensure access to programs for survivors. This study examines patient perspectives in the community-based TrueNTH Lifestyle Management (TrueNTH LM) program in Calgary, Canada.

Methods

Eleven men from programs at civic wellness centers participated in 2 small semistructured focus groups (n = 5 and 6) at the University of Calgary. Motivation for program initiation and adherence, benefits and barriers to participation, and individual satisfaction and feedback on program improvement were discussed. Audio recordings were transcribed and analyzed using thematic methodology guided by a pragmatic philosophy on the patient experience in the program.

Results

Themes identified included perceived benefits of participating (physical, psychological, and social), facilitators for involvement in the PA program (program design, initial free access, tailored to prostate cancer specific needs, psychosocial environment), and opportunities for improvement and sustainability (exercise as a part of standard care, cost structure, home-based options).

Conclusions

These findings provide valuable insight into patient perspectives on effective characteristics of prostate cancer and exercise programs. TrueNTH LM has implemented findings, and ensuring needs (benefits and barriers) are addressed for prostate cancer survivors when entering community-based PA programs.