Cancer Patients Face Barriers to Diet & Exercise: Energy, Cost & Motivation

For individuals navigating a cancer diagnosis, maintaining a healthy lifestyle through proper diet and regular exercise often feels like an insurmountable challenge. Even as the desire to prioritize well-being is frequently present, a new analysis reveals a complex web of barriers—extending far beyond simply lacking motivation—that impede these efforts. These obstacles range from the debilitating fatigue often associated with cancer and its treatment to financial constraints and practical logistical hurdles.

The findings, published in hemonc today and based on a secondary analysis of a national survey of nearly 2,000 cancer patients, underscore the need for a more nuanced understanding of the challenges faced by this population. Researchers, led by Jennifer A. Ligibel, MD, of Dana-Farber Cancer Institute, found that lack of energy (reported by 58.7% of respondents) and physical limitations (52%) were the most commonly cited barriers. The study, which assessed dietary patterns, weight, and exercise among patients at various stages of disease, highlights the critical role of support systems and accessible resources in empowering patients to adopt and maintain healthy habits.

Beyond Motivation: A Multifaceted Struggle

While previous research has established the significant benefits of healthy eating and exercise for cancer patients – including reduced mortality risk for those with obesity-related cancers as demonstrated in a 2025 study, and improved outcomes for those with colon cancer with structured exercise programs – this analysis delves into the specific reasons why these recommendations often go unheeded. It’s not simply a matter of willpower, Dr. Ligibel emphasizes. “People often want to engage in healthy lifestyle behaviors, but they need support and infrastructure.”

The study categorized patients based on disease stage: early-stage treatment (Early/OnTx), post-treatment with no active cancer (Early/PostTx), and metastatic disease undergoing treatment (Mets/OnTx). Interestingly, the barriers varied somewhat depending on the stage. Patients with metastatic disease were significantly more likely to report physical limitations and cancer-related effects as obstacles, while those in the early post-treatment phase were less likely to cite these issues. This suggests that the nature of the challenges evolves as the disease progresses and treatment changes.

The Financial Burden and Logistical Concerns

Cost emerged as a significant barrier, particularly for those attempting to improve their diet. Over half of respondents reported that cost was a factor in limiting their access to healthy foods. This is particularly concerning given that lifestyle interventions are often not covered by insurance, creating a financial burden for patients already facing substantial medical expenses. The researchers noted that the lack of third-party support for lifestyle interventions, even for well-established benefits like exercise, is a critical gap in cancer care.

Logistical challenges, such as transportation and time constraints, were less frequently cited as barriers, but still represented obstacles for a substantial portion of patients. This highlights the importance of considering the practical realities of patients’ lives when developing and implementing lifestyle interventions.

What the Findings Mean for Patient Care

The study’s findings underscore the need for a more holistic approach to cancer care that addresses not only the medical aspects of the disease but also the psychosocial and logistical challenges patients face. Healthcare providers should proactively discuss lifestyle modifications with their patients, but simply offering advice is not enough.

“It’s important to talk about it, but it’s also important to endeavor to figure out what are the resources at your health center, in your community to help patients,” Dr. Ligibel explained. She pointed to programs like Livestrong at the YMCA and Strength After Breast Cancer as examples of initiatives that can provide patients with the support and structure they need to make lasting lifestyle changes. Cancer centers are increasingly offering similar programs, but access remains uneven.

Addressing Systemic Barriers and Future Directions

The analysis also points to a critical need for systemic changes to improve access to affordable, healthy food and accessible exercise programs. Dr. Ligibel advocates for lobbying for insurance coverage of exercise as a component of cancer treatment, citing the compelling evidence demonstrating its benefits. A recent trial, the CHALLENGE Trial, demonstrated that exercise interventions can reduce cancer recurrence and mortality, yet it remains largely unsupported by insurance providers.

Future research should focus on identifying effective strategies for triaging patients to the most appropriate interventions based on their individual needs and limitations. This requires a deeper understanding of the factors that influence patients’ ability to adopt and maintain healthy habits, as well as the development of scalable programs that can reach a wider population. The goal is to move beyond simply telling patients to exercise and eat well, and instead provide them with the tools and support they need to succeed.

The U.S. State Department has issued a security alert for Iran, updating travel guidance for American citizens. While unrelated to cancer care, this serves as a reminder of the broader global context impacting health and well-being, and the importance of staying informed about potential risks when traveling or living abroad.

For more information:

Jennifer A. Ligibel, MD, can be reached at [email protected].