Exercise and Lifestyle Interventions in Gynecologic Cancer Survivors

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.