PURPOSE Healthy lifestyle behaviors, including regular exercise and balanced nutrition, affect quality of life in cancer survivors. However, barriers to adopting these behaviors across the cancer continuum are poorly understood. We evaluated barriers to adopting healthy lifestyle behaviors in a national cohort of patients and survivors of cancer. METHODS ASCO distributed an online survey to adult patients with cancer in the United States from March to June 2020. In this secondary analysis, we evaluated the perceived barriers to incorporating healthy lifestyle behaviors after cancer diagnosis and how they differ by disease stage and treatment status. Descriptive statistics summarized barriers to lifestyle changes. Comparisons across disease stage and treatment status were assessed using Rao-Scott chi-square tests, and weighted multivariable logistic regression modeling identified associated factors. RESULTS Of 2,419 survey respondents, 1,987 were included in this analysis and grouped by disease stage: early stage on-treatment (n = 461), early stage post-treatment (n = 916), and metastatic on-treatment (n = 610). The most common barriers to healthy behaviors included lack of energy (58.7%) and physical limitations (52.0%), with significant differences ( P < .05) in barriers related to time, logistics, cancer effects, and physical limitations across disease stages and treatment groups. Among those not meeting lifestyle guidelines, lack of motivation (51.3%-62.0%) and lack of energy (59.5%-77.0%) were major barriers, with barriers related to time, cancer effects, and physical limitations varying significantly by disease stage and treatment status. CONCLUSION Patients with cancer face multiple barriers to adopting healthy lifestyle behaviors after diagnosis. Targeted interventions based on disease stage and treatment status may help address these challenges.
Wilson et al. (2026) studied this question.