Background: Treatments for breast cancer are invasive, causing visible changes such as loss of the breast, body weight change, and hair loss. These changes in conjunction with the pressure for women to conform to societal beauty standards may lead to body image disturbance in breast cancer survivors (BCS). The aims of this scoping review were to explore the nature, characteristics, and extent of the literature examining resistance exercise or art therapy on body image in BCS; and examine how body image is defined and measured across the studies. Methods: We searched the literature up to January 2020, which included conducting electronic searches of three major databases and checking references of screened articles. Results: Ninety-three articles were identified, 28 underwent full-text screening, with 8 studies eligible for inclusion in the review. Five randomized control trials, one hybrid effectiveness-implementation trial, and two single group studies were found. All studies showed significant within-group difference in body image scores, with two studies showing a between-group difference in favor of resistance exercise. No studies were found combining resistance exercise and art therapy. None of the studies defined the aspect of body image they wished to measure, and only one used theory to inform their research. Discussion: Preliminary evidence supports the benefit of resistance exercise and art therapy as single interventions to improve body image perception among BCS. Findings suggest the need for closer attention to the delivery format of interventions. Future research is needed that is theory-informed, with a clear definition of the aspect of body image of interest, and with body image as the primary outcome.

12002 Background: Falls are a major issue among older patients with cancer and can lead to interruption in cancer treatment. Ample evidence shows resistance and balance training can prevent falls in older adults; however, there is a paucity of evidence regarding exercise on fall prevention in the older cancer population, who often have unique risk factors for falls. Given the new reality of the COVID-19 pandemic, minimizing group gatherings and its associated risks is imperative for older patients, who are a vulnerable population. This study sought to investigate the feasibility of an 8-week, virtual exercise program and its preliminary effects on lower body strength and balance in community-dwelling cancer patients. Methods: Study participants were recruited for this pretest-posttest intervention study using consecutive sampling over a one-year period from the Cross Cancer Institute in Edmonton, Alberta. The intervention entailed leg muscle strengthening and balance training exercises that progressed in difficulty as outlined by the Otago program, and involved a virtual component (facilitated live by a certified exercise physiologist via Zoom meeting platform once a week) and independent at-home training component (twice a week). Lower body strength and balance were assessed using the 5-times chair-stand and the 4-stage balance test, respectively, and were analyzed using the Wilcoxon Signed Rank test. Results: Twenty-seven older patients (mean age 70.1, range 65-76) participated. The most common cancer sites were breast (48%) and prostate (41%). One participant withdrew due to personal reasons unrelated to the program. The remaining 26 participants completed the intervention. Attendance rate for the virtual component was 97.6% and independent component 84.7%. Participants perceived the program as rewarding and enjoyable (100%), felt this program prepared them to exercise on their own (92%), were confident to continue exercising on their own (81%), and would recommend the program to other patients (100%). At baseline, 33% (n = 9) ≥1 fall over the past 6 months. A statistically significant improvement in lower body strength was detected post-intervention ( p =.001), whereas no difference was detected in balance ( p =.059). Conclusions: This virtual, hybrid resistance and balance training program was feasible, overwhelmingly accepted by our older participants, and appeared effective in improving lower body strength. Findings from this study may have potential to inform design of a larger, randomized multi-site study.

Objective The aim of this study is to explore the construct validity of the Body Image Scale for Cancer Questionnaire (BIS) using cognitive interviews. Methods Twelve breast cancer survivors participated in a cognitive interview while completing the BIS. Each participant was asked to think‐out‐loud while answering items, and an interviewer asked probing questions relating to the participants' comprehension, example retrieval, certainty of answer and other decision‐making factors. Interviews were audio recorded and transcribed, and the data were analysed deductively and inductively. Results The participants' interpretations of the questions varied significantly. Several participants perceived the phrasing of some questions to be leading. The participants were able to provide examples of how their physical, physiological and body function affected their body image. The participants expressed positive attitudes towards, and gratitude for their body, which was not captured by the questionnaire. At times, the participants felt uncertain in how to respond appropriately to specific items, and the participants found some items challenging to answer. Finally, the BIS included sensitive questions that elicited emotional reactions and discomfort for some participants. Conclusion The findings of this study provide insight into, and suggestions for potential questionnaire revisions that may enhance the validity and relevance of the BIS for use with breast cancer survivors.

Falls are a major issue among older adults with cancer and lead to interruptions in cancer treatment. Resistance and balance training can prevent falls in older adults, but minimal evidence is available regarding the older cancer population, who often have unique risk factors. We used a pre–post design to assess the feasibility of a remotely delivered exercise program that progressed in difficulty and its efficacy on lower body strength, balance, and falls in older adults with cancer who had prior in-person exercise experience. Twenty-six older adults with cancer completed the intervention. Attendance rate for the virtual component was 97.6% and for the independent component was 84.7%. Participants perceived the program as rewarding and enjoyable (100%), felt this program prepared them to exercise on their own (92%), were confident to continue exercising on their own (81%), and would recommend the program to other patients (100%). The median balance score at baseline and end-of-study was 4 (IQR = 0). The median chair-stand time decreased from 9.2 s (IQR = 3.13) to 7.7 s (IQR = 4.6). A statistically significant difference in lower body strength (r = 0.68, p = 0.001) was detected post-intervention. The findings from this study can inform the design of a larger randomized trial.

Introduction Supervision, tailoring, and flexibility have been proposed as key program elements for delivering successful exercise programs for people with multiple myeloma (MM). However, no studies to date have evaluated the acceptability of an intervention employing these components. The aim of this study was to determine the acceptability of a virtually supported exercise program and eHealth application for people with MM. Methods A qualitative description approach was used. One-on-one interviews were conducted with participants who completed the exercise program. Content analysis was used to analyze verbatim transcripts from interviews. Results Twenty participants were interviewed (64.9 ± 6.7 years of age, n = 12 females). Participants had positive perceptions of the exercise program. Two themes emerged related to strengths/limitations: One Size Does Not Fit All (sub-themes: Supportive & Responsive Programming and Diverse Exercise Opportunities ), and App Usability . Supportive and Responsive Programming was a main strength of the program, characterized as programming that was tailored, involved active support, and delivered by appropriate personnel. The inclusion of Diverse Exercise Opportunities was also regarded as a strength, as it accommodated the preferences of all participants. Related to App Usability, participants felt the app was simple and user friendly but had a few less intuitive components. Conclusion The virtually supported exercise program and eHealth application were acceptable for people with MM. Programs should employ tailoring, active support, and appropriate personnel to bolster acceptability and include both supervised and flexible exercise formats. eHealth apps should be simple to use so technology proficiency is not a barrier to participation. Supplementary Information The online version contains supplementary material available at 10.1007/s00520-023-07762-y.