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.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Siegel RL, Miller KD, Jemal A. Cancer statistics, 2016. CA Cancer J Clin. 2016;66(1):7–30.
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.
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.
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.
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.
Calle EE, Kaaks R. Overweight, obesity and cancer: epidemiological evidence and proposed mechanisms. Nat Rev Cancer. 2004;4(8):579–91.
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.
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.
Mayer DK, Terrin NC, Menon U, et al. Health behaviors in cancer survivors. Oncol Nurs Forum. 2007;34(3):643–51.
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.
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.
Zhang X, Brown JC, Schmitz KH. Association between body mass index and physical function among endometrial cancer survivors. PLoS One. 2016;11(8):e0160954.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
Hwang KH, Cho OH, Yoo YS. The effect of comprehensive care program for ovarian cancer survivors. Clin Nurs Res. 2016;25(2):192–208.
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.
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.
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.
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.
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.
Acknowledgement
This work was supported, in part, by NIH NCI grant R01CA175100 [to N. L. N.].
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights 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)