Associations between physical activity expectations, health literacy, and life satisfaction in cancer patients: results of a quantitative cross-sectional study

Purpose Health literacy, physical activity, and complementary and alternative medicine (CAM) are increasingly recognized as important factors influencing coping strategies, quality of life, and well-being in cancer patients. However, empirical evidence on their interrelationships remains limited. Methods We conducted a multicenter cross-sectional study between April and November 2024 at one Comprehensive Cancer Center and eleven oncological sites across Germany. A total of 316 cancer patients completed a standardized questionnaire assessing health literacy, self-reported sport participation, expectations toward physical activity, affective attitudes toward physical activity, CAM use, spirituality, nutrition, and life satisfaction. Descriptive statistics, reliability analyses, t-tests, and Spearman’s correlations were performed. Results Among the 316 participants, health literacy (M = 3.10, SD = 0.44) and life satisfaction (M = 7.03, SD = 2.02) were high. Health literacy did not differ significantly by self-reported pre-diagnosis sport participation. Life satisfaction likewise did not differ by self-reported pre-diagnosis sport participation. In contrast, more positive affective attitudes toward physical activity were significantly correlated with health-related expectations toward physical activity ( r = 0.580, p < 0.001), body-related motives ( r = 0.471, p < 0.001), and life satisfaction ( r = 0.212, p < 0.001). CAM use was frequent, with 44.9% reporting vitamin D supplementation and 37.5% other vitamins or dietary supplements. Conclusion While self-reported sport participation did not show significant associations with life satisfaction, motivational and cognitive factors—such as positive attitudes and expectations—were linked to health literacy and well-being. These findings highlight the importance of strengthening patient-centered communication, motivational counseling, and health literacy as key elements of integrative oncology.