“As important as medication.” A qualitative investigation of the beliefs, barriers and facilitators of physical activity for women with metastatic breast cancer

Background

Women with metastatic breast cancer (MBC) experience a range of physical and psychological challenges. Physical activity is safe and supports quality of life in individuals with MBC. However, most women with MBC are not meeting physical activity recommendations.

Aims

To inform the development of an accessible and effective physical activity intervention, we investigated the beliefs, barriers and facilitators of physical activity of women with MBC.

Methods

We conducted semi-structured telephone interviews with UK women living with MBC. Participants were asked open-ended questions about physical activity levels, beliefs, barriers, facilitators, support and preferences. Reflexive thematic analysis was used to analyse the transcripts and themes were mapped onto the Theoretical Domains Framework.

Results

23 women with MBC (mean age = 53.7 years; White British = 69.7%) were interviewed between May 2022 and October 2024. Average time since diagnosis was 6 years, 1 month. Most had bone metastases (68.8%). Our analysis generated five themes. Participants generally believed physical activity was important (1) but were limited by physical symptoms (2) and psychological barriers (3). Most women noted a significant lack of physical activity support from healthcare providers (4). They discussed how physical activity could be more accessible for their diverse needs (5), including increasing provision of tailored support.

Conclusions

Improvements in physical activity support for women with MBC are needed. Our findings provide several implications for future interventions. This includes implementing physical activity recommendations, improving knowledge about risks and benefits, and incorporating psycho-social and tailored support which consider the unique needs of the MBC population.