. 2025 Apr 3;33(4):347.

doi: 10.1007/s00520-025-09410-z.

"I've got plenty of energy when I'm doing something I want to do": applying self-determination theory to exercise motivation in people with prostate cancer

Harriet Naismith¹, Haryana M Dhillon^{1

2

3}, Julia Hunter⁴, Renee Bultijnck⁵, Andrew Kneebone^{4

6}, George Hruby^{4

6}, Thomas Eade^{4

6}, Lisa Parker^{4

6}, Rachel Campbell^#^{7

8}, Jasmine Yee^#^{9

10

11

12}

Affiliations

¹ School of Psychology, University of Sydney, Sydney, NSW, Australia.
² Psycho-Oncology Cooperative Research Group, School of Psychology, University of Sydney, Sydney, NSW, Australia.
³ Centre for Medical Psychology and Evidence-Based Decision-Making, School of Psychology, University of Sydney, Sydney, NSW, Australia.
⁴ Dept of Radiation Oncology, Northern Sydney Cancer Centre, Royal North Shore Hospital, St Leonards, Sydney, NSW, Australia.
⁵ Department of Human Structure and Repair, Ghent University, Ghent, Belgium.
⁶ Northern Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.
⁷ School of Psychology, University of Sydney, Sydney, NSW, Australia. r.campbell@sydney.edu.au.
⁸ Psycho-Oncology Cooperative Research Group, School of Psychology, University of Sydney, Sydney, NSW, Australia. r.campbell@sydney.edu.au.
⁹ School of Psychology, University of Sydney, Sydney, NSW, Australia. jasmine.yee@sydney.edu.au.
¹⁰ Psycho-Oncology Cooperative Research Group, School of Psychology, University of Sydney, Sydney, NSW, Australia. jasmine.yee@sydney.edu.au.
¹¹ Centre for Medical Psychology and Evidence-Based Decision-Making, School of Psychology, University of Sydney, Sydney, NSW, Australia. jasmine.yee@sydney.edu.au.
¹² Sydney School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia. jasmine.yee@sydney.edu.au.

^# Contributed equally.

PMID: 40178616
PMCID: PMC11968458
DOI: 10.1007/s00520-025-09410-z

"I've got plenty of energy when I'm doing something I want to do": applying self-determination theory to exercise motivation in people with prostate cancer

Harriet Naismith et al. Support Care Cancer. 2025.

. 2025 Apr 3;33(4):347.

doi: 10.1007/s00520-025-09410-z.

Authors

Affiliations

¹ School of Psychology, University of Sydney, Sydney, NSW, Australia.
² Psycho-Oncology Cooperative Research Group, School of Psychology, University of Sydney, Sydney, NSW, Australia.
³ Centre for Medical Psychology and Evidence-Based Decision-Making, School of Psychology, University of Sydney, Sydney, NSW, Australia.
⁴ Dept of Radiation Oncology, Northern Sydney Cancer Centre, Royal North Shore Hospital, St Leonards, Sydney, NSW, Australia.
⁵ Department of Human Structure and Repair, Ghent University, Ghent, Belgium.
⁶ Northern Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.
⁷ School of Psychology, University of Sydney, Sydney, NSW, Australia. r.campbell@sydney.edu.au.
⁸ Psycho-Oncology Cooperative Research Group, School of Psychology, University of Sydney, Sydney, NSW, Australia. r.campbell@sydney.edu.au.
⁹ School of Psychology, University of Sydney, Sydney, NSW, Australia. jasmine.yee@sydney.edu.au.
¹⁰ Psycho-Oncology Cooperative Research Group, School of Psychology, University of Sydney, Sydney, NSW, Australia. jasmine.yee@sydney.edu.au.
¹¹ Centre for Medical Psychology and Evidence-Based Decision-Making, School of Psychology, University of Sydney, Sydney, NSW, Australia. jasmine.yee@sydney.edu.au.
¹² Sydney School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia. jasmine.yee@sydney.edu.au.

^# Contributed equally.

PMID: 40178616
PMCID: PMC11968458
DOI: 10.1007/s00520-025-09410-z

Abstract

Purpose: Androgen deprivation therapy (ADT) for prostate cancer adversely affects quality of life. Whilst exercise is effective for ameliorating many side effects, most people are inactive, with lack of motivation a key barrier. Self-determination theory (SDT) specifies the quality, rather than quantity, of motivation as essential for optimal engagement. We aimed to explore exercise motivation in men on ADT through the theoretical lens of SDT.

Methods: As part of a mixed-method longitudinal study, semi-structured interviews exploring exercise behaviour and perceptions, were conducted with people receiving ADT for prostate cancer. Thematic analysis identified motivation themes aligned with SDT concepts.

Results: Twenty-four men participated (median age 74 years; ECOG 0: 92%, metastatic: 29%). We identified two key themes: (1) type of exercise motivation and (2) use of need-supportive techniques in exercise environments. Motivations ranged from intrinsic (for enjoyment) to external (compliance with other's expectations). Key strategies to support psychological needs included offering choice in exercise programming, providing meaningful rationales for exercise, tailored guidance from exercise professionals, and social support.

Conclusions: This SDT-grounded study provides insights into motivations driving exercise in people receiving ADT and how social and healthcare contexts influence these motivations. The study underscores the importance of considering exercise motivation when discussing, referring, and designing tailored exercise interventions to ensure they are need-supportive to optimise engagement.

Implications for cancer survivors: This study highlights the importance of exercise interventions that are supportive of psychological needs. Incorporating need-supportive strategies may enhance exercise participation and improve physical and psychosocial outcomes for men receiving ADT.

Keywords: Androgen deprivation therapy; Exercise; Prostate cancer; Qualitative research; Self-determination theory.

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Conflict of interest statement

Declarations. Ethics approval: This study was performed in line with the principles of the Declaration of Helsinki. Ethical approval was obtained through the Northern Sydney Local Health District (HREC 2019/ETH03959). Consent to participate: Written informed consent was obtained from all participants. Competing Interests: The authors declare no competing interests.

Figures

**Fig. 1**
The motivation continuation according to self-determination theory [18]. Adapted from Quested et al. 2021 [19]

See this image and copyright information in PMC

References

1. Crawford ED et al (2019) Androgen-targeted therapy in men with prostate cancer: evolving practice and future considerations. Prostate Cancer Prostatic Dis 22(1):24–38 - DOI - PMC - PubMed
1. Nguyen PL et al (2015) Adverse effects of androgen deprivation therapy and strategies to mitigate them. Eur Urol 67(5):825–836 - DOI - PubMed
1. Storey DJ et al (2012) Clinically relevant fatigue in men with hormone-sensitive prostate cancer on long-term androgen deprivation therapy. Ann Oncol 23(6):1542–1549 - DOI - PubMed
1. Cappuccio F et al (2024) Study on the impact of hormone therapy for prostate cancer on the quality of life and the psycho-relational sphere of patients: ProQoL. Oncol Ther - PMC - PubMed
1. Campbell KL et al (2019) Exercise guidelines for cancer survivors: consensus statement from international multidisciplinary roundtable. Med Sci Sports Exerc 51(11):2375–2390 - DOI - PMC - PubMed

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"I've got plenty of energy when I'm doing something I want to do": applying self-determination theory to exercise motivation in people with prostate cancer

Affiliations

"I've got plenty of energy when I'm doing something I want to do": applying self-determination theory to exercise motivation in people with prostate cancer

Authors

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Abstract

Conflict of interest statement

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