Skip to main content

Exercise and Lifestyle Interventions in Gynecologic Cancer Survivors

  • Chapter
  • First Online:
Focus on Gynecologic Malignancies

Part of the book series: Energy Balance and Cancer ((EBAC,volume 13))

  • 549 Accesses

Abstract

In this chapter, we review trials (randomized and non-randomized) involving exercise and other lifestyle components (dietary counseling) in gynecological cancer survivors. In particular, we focus on endometrial and ovarian cancer survivor trials since the majority of studies have been conducted in these cancer populations. To date, only two randomized controlled trials (RCTs) and two non-randomized trials have been completed in ovarian cancer survivors. In addition, there have been three RCTs and two non-randomized trials in endometrial cancer and two other RCTs are currently underway. There has also been a RCT involving a mixed population of ovarian and endometrial cancer survivors and a RCT involving a mixed population of endometrial cancer survivors and women with endometrial hyperplasia, a precursor to endometrial cancer. Most of the RCTs have involved lifestyle counseling and home-based exercise with walking programs, predominantly.; and, most studies have examined changes in physical activity using self-reported measures. Several, but not all, trials have shown some improvement in quality of life with exercise in gynecologic cancer survivors. Given the limited number of RCTs, there is clearly a need for more lifestyle interventions in gynecological survivors. However, future studies should evaluate supervised exercise programs that include objective measures for evaluating changes in physical activity, cardiopulmonary fitness, physical function and body composition. Given the rising rates of uterine cancer incidence and mortality coupled with the strong associations between obesity and endometrial cancer incidence and mortality, as well as the poor fitness levels in endometrial cancer survivors, there should be a particular focus on providing these programs to endometrial cancer survivors and women with endometrial hyperplasia.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2016. CA Cancer J Clin. 2016;66(1):7–30.

    Article  PubMed  Google Scholar 

  2. Ferlay J, Parkin DM, Steliarova-Foucher E. Estimates of cancer incidence and mortality in Europe in 2008. Eur J Cancer. 2010;46(4):765–81.

    Article  CAS  PubMed  Google Scholar 

  3. Sheikh MA, Althouse AD, Freese KE, et al. USA endometrial cancer projections to 2030: should we be concerned? Future Oncol. 2014;10(16):2561–8.

    Article  CAS  PubMed  Google Scholar 

  4. Renehan AG, Tyson M, Egger M, Heller RF, Zwahlen M. Body-mass index and incidence of cancer: a systematic review and meta-analysis of prospective observational studies. Lancet. 2008;371(9612):569–78.

    Article  PubMed  Google Scholar 

  5. Schmandt RE, Iglesias DA, Co NN, Lu KH. Understanding obesity and endometrial cancer risk: opportunities for prevention. Am J Obstet Gynecol. 2011;205(6):518–25.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Calle EE, Kaaks R. Overweight, obesity and cancer: epidemiological evidence and proposed mechanisms. Nat Rev Cancer. 2004;4(8):579–91.

    Article  CAS  PubMed  Google Scholar 

  7. Kaaks R, Lukanova A, Kurzer MS. Obesity, endogenous hormones, and endometrial cancer risk: a synthetic review. Cancer Epidemiol Biomark Prev. 2002;11(12):1531–43.

    CAS  Google Scholar 

  8. Duong LM, Wilson RJ, Ajani UA, Singh SD, Eheman CR. Trends in endometrial cancer incidence rates in the United States, 1999-2006. J Womens Health (Larchmt). 2011;20(8):1157–63.

    Article  Google Scholar 

  9. Mayer DK, Terrin NC, Menon U, et al. Health behaviors in cancer survivors. Oncol Nurs Forum. 2007;34(3):643–51.

    Article  PubMed  Google Scholar 

  10. Kwon S, Hou N, Wang M. Comparison of physical activity levels between cancer survivors and non-cancer participants in the 2009 BRFSS. J Cancer Surviv. 2012;6(1):54–62.

    Article  PubMed  Google Scholar 

  11. Modesitt SC, Geffel DL, Via J, Weltman L. Morbidly obese women with and without endometrial cancer: are there differences in measured physical fitness, body composition, or hormones? Gynecol Oncol. 2012;124(3):431–6.

    Article  CAS  PubMed  Google Scholar 

  12. Zhang X, Brown JC, Schmitz KH. Association between body mass index and physical function among endometrial cancer survivors. PLoS One. 2016;11(8):e0160954.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Peel AB, Barlow CE, Leonard D, et al. Cardiorespiratory fitness in survivors of cervical, endometrial, and ovarian cancers: The Cooper Center Longitudinal Study. Gynecol Oncol. 2015;138(2):394–7.

    Article  PubMed  Google Scholar 

  14. Arem H, Park Y, Pelser C, et al. Prediagnosis body mass index, physical activity, and mortality in endometrial cancer patients. J Natl Cancer Inst. 2013;105(5):342–9.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Zhou Y, Chlebowski R, Lamonte MJ, et al. Body mass index, physical activity, and mortality in women diagnosed with ovarian cancer: results from the Women’s Health Initiative. Gynecol Oncol. 2014;133(1):4–10.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Lin LL, Brown JC, Segal S, Schmitz KH. Quality of life, body mass index, and physical activity among uterine cancer patients. Int J Gynecol Cancer. 2014;24(6):1027–32.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Stevinson C, Faught W, Steed H, et al. Associations between physical activity and quality of life in ovarian cancer survivors. Gynecol Oncol. 2007;106(1):244–50.

    Article  PubMed  Google Scholar 

  18. Secord AA, Hasselblad V, von Gruenigen VE, et al. Body mass index and mortality in endometrial cancer: A systematic review and meta-analysis. Gynecol Oncol. 2016;140(1):184–90.

    Article  PubMed  Google Scholar 

  19. Koutoukidis DA, Beeken RJ, Lopes S, Knobf MT, Lanceley A. Attitudes, challenges and needs about diet and physical activity in endometrial cancer survivors: a qualitative study. Eur J Cancer Care (Engl). 2016.

    Google Scholar 

  20. von Gruenigen VE, Courneya KS, Gibbons HE, et al. Feasibility and effectiveness of a lifestyle intervention program in obese endometrial cancer patients: a randomized trial. Gynecol Oncol. 2008;109(1):19–26.

    Article  Google Scholar 

  21. von Gruenigen VE, Gibbons HE, Kavanagh MB, et al. A randomized trial of a lifestyle intervention in obese endometrial cancer survivors: quality of life outcomes and mediators of behavior change. Health Qual Life Outcomes. 2009;7:17.

    Article  Google Scholar 

  22. von Gruenigen VE, Frasure H, Kavanagh MB, et al. Survivors of uterine cancer empowered by exercise and healthy diet (SUCCEED): A randomized controlled trial. Gynecol Oncol. 2012;125(3):699–704.

    Article  Google Scholar 

  23. McCarroll ML, Armbruster S, Frasure HE, et al. Self-efficacy, quality of life, and weight loss in overweight/obese endometrial cancer survivors (SUCCEED): a randomized controlled trial. Gynecol Oncol. 2014;132(2):397–402.

    Article  CAS  PubMed  Google Scholar 

  24. Rossi A, Garber CE, Ortiz M, et al. Feasibility of a physical activity intervention for obese, socioculturally diverse endometrial cancer survivors. Gynecol Oncol. 2016;142(2):304–10.

    Article  PubMed  Google Scholar 

  25. Nock NL, Dimitropoulos A, Rao SM, et al. Rationale and design of REWARD (revving-up exercise for sustained weight loss by altering neurological reward and drive): a randomized trial in obese endometrial cancer survivors. Contemp Clin Trials. 2014;39(2):236–45.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Alberts JL, Linder SM, Penko AL, Lowe MJ, Phillips M. It is not about the bike, it is about the pedaling: forced exercise and Parkinson's disease. Exerc Sport Sci Rev. 2011;39(4):177–86.

    PubMed  Google Scholar 

  27. Alberts JL, Phillips M, Lowe MJ, et al. Cortical and motor responses to acute forced exercise in Parkinson's disease. Parkinsonism Relat Disord. 2016;24:56–62.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Ridgel AL, Vitek JL, Alberts JL. Forced, not voluntary, exercise improves motor function in Parkinson’s disease patients. Neurorehabil Neural Repair. 2009;23(6):600–8.

    Article  PubMed  Google Scholar 

  29. Koutoukidis DA, Beeken RJ, Manchanda R, et al. Diet and exercise in uterine cancer survivors (DEUS pilot) - piloting a healthy eating and physical activity program: study protocol for a randomized controlled trial. Trials. 2016;17(1):130.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Basen-Engquist K, Carmack CL, Perkins H, et al. Design of the steps to health study of physical activity in survivors of endometrial cancer: testing a social cognitive theory model. Psychol Sport Exerc. 2011;12(1):27–35.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Basen-Engquist K, Carmack C, Brown J, et al. Response to an exercise intervention after endometrial cancer: differences between obese and non-obese survivors. Gynecol Oncol. 2014;133(1):48–55.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  32. Smits A, Lopes A, Das N, et al. The effect of lifestyle interventions on the quality of life of gynaecological cancer survivors: A systematic review and meta-analysis. Gynecol Oncol. 2015;139(3):546–52.

    Article  PubMed  Google Scholar 

  33. Hwang KH, Cho OH, Yoo YS. The effect of comprehensive care program for ovarian cancer survivors. Clin Nurs Res. 2016;25(2):192–208.

    Article  PubMed  Google Scholar 

  34. von Gruenigen VE, Frasure HE, Kavanagh MB, et al. Feasibility of a lifestyle intervention for ovarian cancer patients receiving adjuvant chemotherapy. Gynecol Oncol. 2011;122(2):328–33.

    Article  Google Scholar 

  35. Moonsammy SH, Guglietti CL, Santa MD, et al. A pilot study of an exercise & cognitive behavioral therapy intervention for epithelial ovarian cancer patients. J Ovarian Res. 2013;6(1):21.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Donnelly CM, Blaney JM, Lowe-Strong A, et al. A randomised controlled trial testing the feasibility and efficacy of a physical activity behavioural change intervention in managing fatigue with gynaecological cancer survivors. Gynecol Oncol. 2011;122(3):618–24.

    Article  CAS  PubMed  Google Scholar 

  37. Haggerty AF, Huepenbecker S, Sarwer DB, et al. The use of novel technology-based weight loss interventions for obese women with endometrial hyperplasia and cancer. Gynecol Oncol. 2016;140(2):239–44.

    Article  PubMed  Google Scholar 

  38. McCarroll ML, Armbruster S, Pohle-Krauza RJ, et al. Feasibility of a lifestyle intervention for overweight/obese endometrial and breast cancer survivors using an interactive mobile application. Gynecol Oncol. 2015;137(3):508–15.

    Article  PubMed  Google Scholar 

Download references

Acknowledgement

This work was supported, in part, by NIH NCI grant R01CA175100 [to N. L. N.].

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Nora L. Nock Ph.D. .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG

About this chapter

Cite this chapter

Nock, N.L. (2018). Exercise and Lifestyle Interventions in Gynecologic Cancer Survivors. In: Berger, N., Klopp, A., Lu, K. (eds) Focus on Gynecologic Malignancies. Energy Balance and Cancer, vol 13. Springer, Cham. https://doi.org/10.1007/978-3-319-63483-8_12

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-63483-8_12

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-63482-1

  • Online ISBN: 978-3-319-63483-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics