A pilot study of an exercise & cognitive behavioral therapy intervention for epithelial ovarian cancer patients

Blogger's Note:
2011; small study; ("Consequently of the 46 participants who were eligible, 13 patients declined and 14 could not be reached for follow-up contact." (n=19)); no stage IV; mean age=52/57; CBT (cognitive behavioural therapy) had high attrition rate;  study (cognitive behaviour) did not describe if ovarian cancer survivours were also connected to online, face-to-face or other supportive/peer groups etc....

Blogger's Opinion - aside from recognizing (finally) that ovarian cancer patients' treatment/s can lead to increased weight gain, something rarely recognized or understood by media/public, the value of this study is limited



open access

Background

Ovarian cancer has the highest mortality rate of all gynaecologic cancers. Faced with poor prognoses, stressful treatment effects and a high likelihood of recurrence, survivors must confront significant physical and psychological morbidities that negatively impact health-related quality of life. Frequently reported side effects include cancer-related fatigue, peripheral neuropathy, and psychological distress. Exercise and cognitive behavioral therapy interventions have counteracted such adverse effects in other cancer populations.

Objective

To investigate the feasibility and benefits of a 24-week home-based exercise intervention, coordinated with 12 weeks of cognitive behavioral therapy (two sessions per month), developed for two types of patients diagnosed with epithelial ovarian cancer: 1) those undergoing primary treatment with adjuvant chemotherapy after primary surgery; 2) those on surveillance after completing treatment within the last 2 years.

Methods

Participants were recruited from the Gynaecologic Oncology Clinic. Eligible participants completed baseline assessments and were provided with home-based exercise equipment. Cognitive behavioral therapy was provided every other week for patients via telephone. Assessments were completed at baseline (T1), 3 months (T2) and 6 months (T3).

Results

19 of the 46 eligible patients approached were enrolled, with 7 patients in the treatment group and 12 in the surveillance group. There was a significant within group increase in peak VO2 from baseline to 6 months: F(2,16) = 5.531, p = 0.015, partial eta2 = 0.409.

Conclusion

The combined 6-month exercise-cognitive behavioral therapy intervention was associated with significant increases in aerobic fitness in epithelial ovarian cancer patients assessed. These improvements were similar regardless of whether the patient was receiving chemotherapy or under surveillance.

The complete article is available as a provisional PDF. The fully formatted PDF and HTML versions are in production.

 Discussion

 There was a significant increase in aerobic fitness from baseline to 6 months in both treatment and surveillance patients. Although adherence to the exercise program was not available, the increase in VO2 peak suggests that participants likely participated in some form
of regular physical activity which leads to improved cardiovascular functioning. A recent meta-analysis reports that aerobic exercise interventions improve cardiopulmonary function and body composition in women with breast cancer [60]. There were significant increases in waist circumference and body fat percentage that is typically seen with chemotherapy treatment [61]. The greatest weight gain is typically observed in women who become
menopausal during treatment [61]. Participants with the greatest gain in body fat percentage may have gained weight as a result of treatment related effects. It can be attributed to
treatment related changes such as hormonal changes, supportive medication given such as steroids to prevent nausea and psychosocial factors [61]. However, it is unclear whether the gain in adiposity was attenuated by exercise or whether the increased cardiovascular function resulted from the intervention given the absence of a control condition and adherence data.......

"...Participants in the study all completed more than half of the telephone based cognitive behavioural therapy counselling sessions. It was found that the CBT portion of the study provided no additional benefits, as everyone in the study adhered to the CBT counselling. Although no immediate benefits for CBT were observed, it is suggested that CBT interventions are most beneficial on QOL factors in longer-term follow-up periods [45,46]....