Tamara L Jones

The Swaying Pendulum: Factors Influencing Physical Activity Participation in Women With Recurrent Ovarian Cancer

Background: Physical activity levels decline following diagnosis of ovarian cancer, and there is limited research investigating the factors that influence participation across the cancer continuum. The objective of this study is to explore barriers, facilitators, perceptions, and preferences of physical activity for women with recurrent ovarian cancer and to explore whether these factors change across the cancer continuum. Methods: Women enrolled in the Exercise During Chemotherapy for Recurrent Ovarian Cancer trial were invited to participate. Semistructured interviews, guided by social cognitive theory, were conducted by 2 interviewers via video conferencing. All interviews were recorded and transcribed verbatim. Data were analyzed using an adaptive thematic approach. Results: An overarching theme, “The swaying pendulum,” emerged following 13 participant interviews, representing the instability of physical activity participation in women with recurrent ovarian cancer. Five themes captured factors swaying the “pendulum”: (1) the “priority ladder” of physical activity and the importance of social support and the physical environment, (2) the “hurdles” of treatment- and disease-related side effects, (3) the power of physical activity support and advice from health professionals in the face of uncertainty and fear, (4) a “yearning” for the outdoors, and (5) resorting to walking. Conclusions: Physical activity participation in women with recurrent ovarian cancer is swayed by a complex combination of internal and external factors, unique to each individual, and continually changing circumstances across the cancer continuum.

Physical activity levels among ovarian cancer survivors: a prospective longitudinal cohort study

Physical activity following cancer diagnosis is associated with improved outcomes, including potential survival benefits, yet physical activity levels among common cancer types tend to decrease following diagnosis and remain low. Physical activity levels following diagnosis of less common cancers, such as ovarian cancer, are less known. The objectives of this study were to describe physical activity levels and to explore characteristics associated with physical activity levels in women with ovarian cancer from pre-diagnosis to 2 years post-diagnosis. As part of a prospective longitudinal study, physical activity levels of women with ovarian cancer were assessed at multiple time points between pre-diagnosis and 2 years post-diagnosis. Physical activity levels and change in physical activity were described using metabolic equivalent task hours and minutes per week, and categorically (sedentary, insufficiently, or sufficiently active). Generalized Estimating Equations were used to explore whether participant characteristics were related to physical activity levels. A total of 110 women with ovarian cancer with a median age of 62 years (range 33-88) at diagnosis were included. 53-57% of the women were sufficiently active post-diagnosis, although average physical activity levels for the cohort were below recommended levels throughout the 2-year follow-up period (120-142.5min/week). A decrease or no change in post-diagnosis physical activity was reported by 44-60% of women compared with pre-diagnosis physical activity levels. Women diagnosed with stage IV disease, those earning a lower income, those receiving chemotherapy, and those currently smoking or working were more likely to report lower physical activity levels and had increased odds of being insufficiently active or sedentary. Interventions providing patients with appropriate physical activity advice and support for behavior change could potentially improve physical activity levels and health outcomes.