***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: PURPOSE / OBJECTIVES To examine determinants of exercise during colorectal cancer treatment using the theory of planned behavior . DESIGN A retrospective survey . SETTING Cancer Registry of Alberta , Canada . SAMPLE R and omly selected survivors of colorectal cancer ( N = 110 ) diagnosed between 1992 and 1995 who had undergone adjuvant therapy . Participants ' ages ranged from 26 to 77 years ( mean = 61 years ; SD = 11 ) , 63 % were male , and 85 % were disease stage II or III . METHODS Initial open-ended elicitation question naire to determine salient beliefs , a mailed main question naire , a postcard reminder one week later , and a second question naire three weeks later . Exercise  was assessed by the Godin Leisure Time Exercise Question naire . MAIN RESEARCH VARIABLES Exercise during cancer treatment , intention , perceived behavioral control , attitude , subjective norm , and salient beliefs . FINDINGS Exercise during cancer treatment was determined by intention and perceived behavioral control . Intention was determined solely by attitude . Salient beliefs about exercise were different for patients with cancer as compared to a healthy population . CONCLUSIONS The theory of planned behavior may be a viable framework on which to base interventions to promote exercise in patients with colorectal cancer . IMPLICATION S FOR NURSING PRACTICE Oncology nurses need to have an underst and ing of motivational factors related to exercise during cancer treatment to be able to assist patients with cancer to initiate and maintain exercise Background : Although exercise has been addressed as an adjuvant treatment for anxiety , depression and cancer-related symptoms , limited studies have evaluated the effectiveness of exercise in patients with lung cancer . Methods : We recruited 116 patients from a medical centre in northern Taiwan , and r and omly assigned them to either a walking-exercise group ( n=58 ) or a usual-care group ( n=58 ) . We conducted a 12-week exercise programme that comprised home-based , moderate-intensity walking for 40 min per day , 3 days per week , and weekly exercise counselling . The outcome measures included the Hospital Anxiety and Depression Scale and the Taiwanese version of the MD And erson Symptom Inventory . Results : We analysed the effects of the exercise programme on anxiety , depression and cancer-related symptoms by using a generalised estimating equation method . The exercise group patients exhibited significant improvements in their anxiety levels over time ( P=0.009 and 0.006 in the third and sixth months , respectively ) and depression ( P=0.00006 and 0.004 in the third and sixth months , respectively ) than did the usual-care group patients . Conclusions : The home-based walking exercise programme is a feasible and effective intervention method for managing anxiety and depression in lung cancer survivors and can be considered as an essential component of lung cancer rehabilitation Exercise is recommended following cancer diagnosis and may be particularly valuable for women receiving cardiotoxic chemotherapy treatments . We investigated breast cancer patient preference on exercise programming in a prospect i ve manner and retrospectively assessed length of time between diagnosis and chemotherapy initiation . Sixty-seven newly diagnosed breast cancer patients responded to questions regarding exercise programming related to cancer treatment and surveys on current activity level . Additionally , a retrospective chart review was conducted on 500 r and om breast cancer patients . Age , cancer stage , treatment , and treatment date s were extracted . Women were interested in , or , absolutely wanted to , participate in an exercise program  before treatment ( 76.2 % ) . There was uncertainty regarding willingness to delay treatment ; 49.2 % were willing to delay their treatment if the program was recommended by their doctors , 41.8 % would not , and 9.0 % were too unsure to respond . However , women would like to hear information about an exercise program for cancer patients when they are first diagnosed ( 61.9 % ) . We observed that 64.6 % of women were below recommended levels of physical activity ; yet , current activity was not associated with an interest in an exercise program or willingness to delay treatment . Retrospectively , we observed an average interval of 72.6 ± 34.6 days between cancer diagnosis and initiation of anthracycline-based chemotherapy treatment , with younger women with more advanced cancer receiving anthracycline-based chemotherapy  . Based on patient preference and length of time to  chemotherapy  initiation , a reasonable next step to promote the current recommendations for exercise could be to integrate exercise into breast cancer care earlier in treatment BACKGROUND Development of this guideline was undertaken by the Exercise for People with Cancer Guideline Development Group , a group organized by Cancer Care Ontario 's Program in Evidence -Based Care ( pebc ) . The purpose of the guideline was to provide guidance for clinicians with respect to exercise for patients living with cancer , focusing on the benefits of specific types of exercise , recommendations about screening requirements for new referrals , and safety concerns . METHODS Consistent with the pebc 's st and ardized approach , a systematic search was conducted for existing guidelines , and systematic literature search es were performed in medline and embase for both systematic review s and primary literature . Content and methodology experts performed an internal review , which was followed by an external review by targeted experts and intended users . RESULTS The search identified three guidelines , eighteen systematic review s , and twenty-nine r and omized controlled trials with relevance to the topic . The present guideline provides recommendations for the duration , frequency , and intensity of exercise appropriate for people living with cancer . It also provides recommendations for pre-exercise assessment , safety concerns , and delivery models . CONCLUSIONS There is sufficient evidence to show that exercise provides benefits in quality of life and muscular and aerobic fitness for people with cancer both during and after treatment , and that it does not cause harm . The present guideline is intended to support the Canadian Society for Exercise Physiology 's Canadian physical activity guidelines . The recommendations are intended for clinicians and institutions treating cancer patients in Ontario , and for policymakers and program planners involved in the delivery of exercise programs for cancer patients OBJECTIVE Evidence of the benefits of exercise for those treated for cancer has led to exercise interventions for this population . Some have question ed whether cancer patients offered a home-based intervention  adhere to the exercise prescribed . METHOD We examined exercise adherence in a r and omized controlled trial of a 12-week ,  home-based exercise trial for breast cancer patients . Three adherence outcomes were examined : minutes of exercise participation/week , number of steps taken during planned exercise/week  , and whether the participant met her weekly exercise goal . Predictors of adherence ( e.g. demographic and medical variables , Transtheoretical Model variables , history of exercise ) were examined . RESULTS Findings indicate that participants significantly increased their minutes of exercise and steps taken during planned exercise from Week 1 to 12 . The percentage of participants achieving exercise goals was highest in the first few weeks . Exercise self-efficacy significantly predicted each adherence outcome . Baseline PA predicted mean exercise session steps over the 12 weeks . CONCLUSION Adherence to a home-based exercise intervention for breast cancer patients changes over time and may be related to baseline levels of exercise self-efficacy PURPOSE / OBJECTIVES To examine the effects of an acute bout of exercise on state anxiety in breast cancer survivors . DESIGN A two-group ( high and low state anxiety ) by two-time ( pre- and postexercise ) mixed factorial design . SETTING Exercise physiology lab at the University of Alberta . SAMPLE 34 stage I or II breast cancer survivors ranging in age from 39 - 65 ( X = 50.50 ; SD = 6.62 ) . METHODS Participants completed the  State Anxiety Inventory prior to and five minutes following an acute bout of exercise . MAIN RESEARCH VARIABLES State anxiety . FINDINGS A main effect result ed for group ( p < 0.01 ) and time showing that state anxiety significantly decreased from pre- to postexercise ( p < 0.03 ) . Group by time interaction showed that state anxiety for the low state anxiety group did not change from pre- to postexercise ( p > 0.05 ) ; however , state anxiety significantly decreased in the high state anxiety group ( p < 0.03 ) . CONCLUSION Acute exercise may be an effective intervention in reducing state anxiety in breast cancer survivors , especially those with high state anxiety . IMPLICATION S FOR NURSING PRACTICE Oncology nurses should be aware that in addition to other traditional anxiolytic therapies ( e.g. , relaxation therapy ) commonly prescribed , acute exercise is an effective method for reducing state anxiety in breast cancer survivors BACKGROUND Despite the high global prevalence of prostate cancer ( PCa ) , few epidemiologic studies have assessed physical activity in relation to PCa survival . OBJECTIVE To evaluate different types , intensities , and timing of physical activity relative to PCa survival . DESIGN , SETTING , AND PARTICIPANTS A prospect i ve study was conducted in Alberta , Canada , in a cohort of 830 stage II-IV incident PCa cases diagnosed between 1997 and 2000 with follow-up to 2014 ( up to 17 yr ) . Prediagnosis lifetime activity was self-reported at diagnosis . Postdiagnosis activity was self-reported up to three times during follow-up . OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Cox proportional hazards models related  physical activity to all-cause and PCa-specific deaths and to first recurrence/progression of PCa . RESULTS AND LIMITATIONS A total of 458 deaths , 170 PCa-specific deaths , and , after first follow-up , 239 first recurrences/progressions occurred . Postdiagnosis  total  activity ( > 119 vs ≤42 metabolic equivalent [MET]-hours/week per year ) was associated with a significantly lower all-cause mortality risk ( hazard ratio [ HR ] : 0.58 ; 95 % confidence interval [ CI ] , 0.42 - 0.79 ; p value for trend < 0.01 ) . Postdiagnosis recreational activity ( > 26 vs ≤4 MET-hours/week per year ) was associated with a significantly lower PCa-specific mortality risk ( HR : 0.56 ; 95 % CI , 0.35 - 0.90 ; p value for trend = 0.01 ) .  Sustained recreational activity before and after diagnosis ( > 18 - 20 vs < 7 - 8 MET-hours/week per year ) was associated with a lower risk of all-cause mortality ( HR : 0.66 ; 95 % CI , 0.49 - 0.88 ) . Limitations included generalisability to healthier cases and an observational study design . CONCLUSIONS These findings support emerging recommendations to increase physical activity after the diagnosis of PCa and would inform a future exercise intervention trial examining PCa outcomes . PATIENT SUMMARY In a 17-yr prostate cancer ( PCa ) survival study , men who survived at least 2 yr who were more physically active postdiagnosis or  performed more recreational physical activity  before and after diagnosis survived longer . Recreational physical activity  after diagnosis was associated with a lower risk of PCa death This study examined the effect of a supervised , aerobic exercise program on change in body weight and composition ( multi-site subcutaneous skinfold measures , percent body fat , and lean body weight ) of women undergoing adjuvant chemotherapy for breast cancer . Stage II patients with breast cancer ( N = 24 ) were r and omized to an exercise treatment group ( EG , n = 12 ) and a control group ( CG , n = 12 ) . The EG participated in the individualized Winningham Aerobic Interval Training ( WAIT ) exercise program with exertional levels set at 60%-85 % of maximal heart rate for 20 - 30 minutes , 3 times per week , for 10 - 12 weeks . The CG received no exercise treatment , but were asked to continue with their daily activities . Subjects were asked to maintain their customary eating patterns throughout their participation . Data were analyzed using covariate analysis , adjusting for age and pre-test values . Comparisons of pre- and post-test results indicated that exercise had a moderating effect on gain in body fat and altered the subcutaneous body fat profile in both obese ( OB ) and nonobese ( NOB ) subjects . Exercising OB subjects showed a greater increase in lean body weight than NOB subjects , indicating an increase in muscle tissue . Results from this study may be useful in design ing safe and effective weight-control programs for patients with breast cancer on chemotherapy PURPOSE Physically active individuals have a lower risk of developing colorectal cancer but the influence of exercise on cancer survival is unknown . PATIENTS AND METHODS By a prospect i ve , observational study of 573 women with stage I to III colorectal cancer , we studied colorectal cancer-specific and overall mortality according to predefined physical activity categories before and after diagnosis and by change in activity after diagnosis . To minimize bias by occult recurrences , we excluded women who died within 6 months of their postdiagnosis physical activity assessment . RESULTS Increasing levels of exercise after diagnosis of nonmetastatic colorectal cancer reduced cancer-specific mortality ( P for trend = .008 ) and overall mortality ( P for trend = .003 ) . Compared with women who engaged in less than 3 metabolic equivalent task [ MET ] -hours per week of physical activity , those engaging in at least 18 MET-hours per week had an adjusted hazard ratio for colorectal cancer-specific mortality of 0.39 ( 95 % CI , 0.18 to 0.82 ) and an adjusted hazard ratio for overall mortality of 0.43 ( 95 % CI , 0.25 to 0.74 ) . These results remained unchanged even after excluding women who died within 12 and 24 months 
    Output:
    
Most cancer survivors felt able and interested in participating in a PA program  , though starting a PA program after or before treatment was preferred .
Walking was the strongest PA modality preference , and most cancer survivors preferred moderate intensity PA .
Cancer survivors also indicated preferences for  home-based PA  that could take place in the morning .
Slight preferences were found towards physical activity counseling delivered by a fitness expert from a cancer center .
Conclusion Cancer survivors have an interest in participating in PA programs with walking as the primary modality .
Additionally , morning-based PA programs that can be tapered to home-based programs are desirable .
However , there was wide variation in other  PA preference variables , suggesting multiple program options would be beneficial .