Three themes were identified impacting how individuals living with APC perceive and experience exercise: (1) Taking control of my journey; (2) Building the motivation; and (3) If it was a program for me, highlighting the importance of progressive programming, realistic goal setting, and fostering of a supportive environment.
Key Findings
Results
Individuals living with advanced pancreatic cancer (APC) perceived exercise as a means of taking control of their cancer journey.
This theme was identified through semi-structured interviews with 6 individuals diagnosed with advanced (stage III or IV) exocrine pancreatic cancer from across Canada.
The theme 'Taking control of my journey' reflects participants' desire for agency and autonomy in their care despite a poor prognosis and high symptom burden.
Qualitative interpretive description methodology was used, with reflexive thematic analysis applied to verbatim transcripts.
Both inductive and deductive analysis were conducted using the Behaviour Change Wheel and Theoretical Domains Framework as guiding lenses.
Results
Building motivation was identified as a key theme influencing exercise experiences and perspectives among individuals with APC.
The theme 'Building the motivation' was one of three themes identified from interviews with 6 APC participants.
Motivation-related factors were analyzed through the lens of the Behaviour Change Wheel and Theoretical Domains Framework.
The study highlights that motivational barriers and facilitators are central to how individuals with advanced disease perceive exercise.
The sample consisted of individuals diagnosed with stage III or IV exocrine pancreatic cancer recruited from across Canada.
Results
Participants expressed a desire for individualized, tailored exercise programming specifically designed for people with advanced pancreatic cancer.
The theme 'If it was a program for me' indicated that participants wanted exercise interventions adapted to their specific disease context and needs.
Integration of progressive programming and realistic goal setting were identified as important considerations for the care context.
Fostering of a supportive environment was also identified as an important consideration alongside individualized programming.
This theme underscores a gap in existing exercise offerings perceived by individuals living with APC.
Background
There is limited research exploring the role and integration of exercise within advanced pancreatic cancer care despite exercise being an evidence-based approach to improving health outcomes in cancer.
The study notes that exercise training is 'an evidence-based approach in improving physical and psychological health outcomes in those living with and beyond a cancer diagnosis.'
The study was motivated by a recognized gap in research specifically addressing exercise in advanced, rather than early-stage or post-treatment, pancreatic cancer.
Only 6 participants were available for recruitment, suggesting the population is difficult to access, likely due to poor prognosis and high symptom burden.
Participants were diagnosed with advanced (stage III or IV) exocrine pancreatic cancer, representing one of the most challenging oncological contexts.
Methods
The study used a qualitative interpretive description methodology with reflexive thematic analysis guided by established behavior change frameworks to explore exercise perceptions in APC.
Semi-structured interviews were conducted with 6 individuals diagnosed with advanced (stage III or IV) exocrine pancreatic cancer from across Canada.
Interviews were transcribed verbatim and analyzed using reflexive thematic analysis.
Both inductive and deductive analysis were conducted using the Behaviour Change Wheel and Theoretical Domains Framework as guiding analytical lenses.
The qualitative interpretive description methodology was chosen to explore the subjective experiences and perspectives of the participants.
Conclusions
Progressive programming, realistic goal setting, and a supportive environment were identified as important considerations for integrating exercise into advanced pancreatic cancer care.
These three considerations emerged from thematic analysis of interviews with 6 APC participants.
These findings are positioned as relevant to the specific 'care context' of advanced pancreatic cancer in Canada.
The identification of these elements suggests that standard exercise programming may not be appropriate without modification for this population.
These recommendations align with the overarching theme that participants sought exercise programs tailored specifically to their condition and circumstances.
What This Means
This research explores how people living with advanced pancreatic cancer (stage III or IV) in Canada think about and experience exercise. Because pancreatic cancer at this stage carries a poor prognosis and significant physical symptoms, it is a particularly challenging context in which to integrate exercise — and very little research has examined this specific situation before. The researchers interviewed six Canadians with advanced pancreatic cancer about their exercise experiences and perspectives, then analyzed those conversations using established frameworks for understanding behavior change.
The study found three major themes in how participants perceived exercise: first, exercise gave them a sense of control over their cancer journey at a time when much felt out of their hands; second, building and maintaining motivation was a central challenge and facilitator; and third, participants strongly felt they needed programs specifically designed for people in their situation — not generic exercise plans. Participants indicated that having realistic goals, programs that gradually increased in difficulty, and a supportive environment were all important to making exercise feel accessible and worthwhile.
This research suggests that exercise could play a meaningful role in the care of people with advanced pancreatic cancer, but that standard exercise programs may not meet this population's needs without significant tailoring. Healthcare providers and program developers working in palliative and supportive cancer care may want to consider how to design and offer exercise opportunities that are progressive, individualized, and delivered within a supportive framework — acknowledging both the physical limitations and the psychological importance of autonomy for people facing advanced disease.
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Cyr C, Perry B, Ramjeesingh R, Blanchard C, Keats M. (2026). Exploring patient perspectives of exercise in advanced pancreatic cancer care in Canada: A qualitative interpretive description.. Palliative & supportive care. https://doi.org/10.1017/S1478951526103356