Associations among exercise, body weight, and quality of life in a population-based sample of endometrial cancer survivors

Associations between physical activity and quality of life in ovarian cancer survivors

OBJECTIVES

To estimate the prevalence of physical activity in ovarian cancer survivors and to determine if there is a dose-response relationship between physical activity and quality of life.

METHODS

Ovarian cancer survivors identified from a Canadian provincial cancer registry were mailed a questionnaire measuring self-reported leisure time physical activity (Godin Leisure Time Exercise Questionnaire), cancer-specific quality of life (Functional Assessment of Cancer Therapy-Ovarian), and standard demographic and medical variables.

RESULTS

Completed questionnaires were received from 359 (51.4%) participants. Analyses indicated that 31.1% were meeting public health physical activity guidelines (i.e., at least 60 min of strenuous or 150 min of moderate/strenuous physical activity per week). Comparisons using different volumes of physical activity showed support for the current guidelines. Specifically, participants meeting current physical activity guidelines reported significantly better quality of life than those not meeting guidelines [mean difference: 12.5; 95% CI: 9.1 to 16.0; p<0.001; d=0.75]. Disease status was the only variable to moderate this association. Adjusting for important demographic and medical variables did not alter the findings.

CONCLUSIONS

Few ovarian cancer survivors are meeting public health physical activity guidelines, but those that are meeting guidelines report significantly and meaningfully better quality of life. Clinical trials investigating the causal effects of physical activity on quality of life in ovarian cancer survivors are warranted.

Correlates of exercise motivation and behavior in a population-based sample of endometrial cancer survivors: an application of the Theory of Planned Behavior

Background

Despite evidence of the benefits of exercise in cancer survivors, exercise participation rates tend to decline after treatments. Few studies have examined the determinants of exercise in less common cancer sites. In this study, we examined medical, demographic, and social cognitive correlates of exercise in endometrial cancer survivors using the Theory of Planned Behavior (TPB).

Methods

A mailed survey was completed by 354 endometrial cancer survivors (1 to 10 years postdiagnosis) residing in Alberta, Canada. The study was cross-sectional. Exercise behavior was assessed using the Godin Leisure Time Exercise Questionnaire and the TPB constructs were assessed with standard self-report scales. Multiple regression analyses were used to determine the independent associations of the TPB constructs with intention and behavior.

Results

Chi-square analyses indicated that marital status (p = .003), income level (p = .013), and body mass index (BMI) (p = .020) were associated with exercise. The TPB explained 34.1% of the variance in exercise behavior with intention (β = .38, p < .001) and self-efficacy (β = .18, p = .029) being independent correlates. For intention, 38.3% of the variance was explained by the TPB with self-efficacy (β = .34, p < .001) and affective attitude (β = .30, p < .001) being the independent correlates. The TPB mediated the associations of marital status and BMI with exercise but not income level. Age and BMI moderated the associations of the TPB with intention and behavior.

Conclusion

The TPB may be a useful framework for understanding exercise in endometrial cancer survivors. Exercise behavior change interventions based on the TPB should be tested in this growing population.

Associations of leisure-time physical activity with quality of life in a large, population-based sample of colorectal cancer survivors

OBJECTIVE

To examine the associations between physical activity and quality of life for colorectal cancer survivors; and to describe the associations of medical and sociodemographic attributes with overall quality of life, and their moderating effects on the relationships between physical activity and quality of life.

METHODS

Telephone interviews were conducted with 1,996 colorectal cancer survivors recruited through the Queensland Cancer Registry. Data were collected on current quality of life; leisure-time physical activity pre- and post-diagnosis; cancer treatment and side-effects; and general sociodemographic attributes. Hierarchical generalized linear models identified variables significantly associated with quality of life.

RESULTS

After controlling for sociodemographic variables, disease-specific variables, treatment side-effects, and pre-diagnosis leisure-time physical activity, there were significant differences in quality of life scores by post-diagnosis physical activity category. Compared to participants who were inactive after their diagnosis, those who were sufficiently active had a 17.0% higher total quality of life score. Physical activity also had a significant independent positive association with the physical well-being, functional well-being, and additional concerns subscales of the FACT-C.

CONCLUSIONS

Our findings demonstrate that quite modest changes in leisure-time physical activity are associated with quality of life. Colorectal cancer survivors may benefit from a more active lifestyle.

Association between physical activity and quality of life among Western Australian breast cancer survivors

Previous research has shown that physical activity (PA) may be beneficial to quality of life (QoL) in breast cancer survivors. Few studies however, have focused on the time period soon after the completion of adjuvant therapy or examined exercise issues separately for rural/urban or healthy weight/obese breast cancer survivors. Our study addressed these issues. Breast cancer survivors (N = 558) from the Western Australia Cancer Registry completed a survey that included the Godin Leisure Time Exercise Questionnaire (GLTEQ) and the Functional Assessment of Cancer Therapy-Breast (FACT-B) scale. Results showed that only 31% of breast cancer survivors were meeting the recommended PA guidelines post-treatment. Analysis of variance revealed that survivors meeting these guidelines reported higher scores on the FACT-B (mean difference 8.6; 95% CI = 5.0-12.1; p<0.001), the FACT-General (mean difference 6.3; 95% CI = 3.5-9.0; p<0.001), the trial outcome index (TOI; p<0.001), and several of the FACT-B subscales. Furthermore, healthy weight participants also reported higher scores than obese participants on the FACT-B (p = 0.058) and the breast cancer subscale (p = 0.033). There were no differences based on geographic location. We conclude that physically active and healthy weight breast cancer survivors report better QoL than their inactive and obese counterparts soon after completing adjuvant therapy.

Exercise interest and preferences among patients diagnosed with primary brain cancer

GOALS OF THE WORK

The purpose of the present investigation was to examine the interest and exercise preferences of an institution-based sample of brain tumor patients. Secondary aims were to examine potential differences in participant's interest and preferences by exercise behavior and select demographic/medical variables.

MATERIALS AND METHODS

Using a cross-sectional design, 106 brain tumor patients (age range, 32 to 83 years) who received treatment at the Preston Robert Tisch Brain Tumor Center (BTC) at Duke completed a questionnaire that assessed self-reported exercise behavior, exercise interest and preferences during active and off-treatment periods.

MAIN RESULTS

For exercise program preferences, participants were significantly more interested and felt more capable of participating in an exercise program following compared to during adjuvant therapy. Approximately equal proportions of brain tumor patients preferred to exercise at home with their spouse or other family members. These preferences were consistent across both cancer treatment-related time periods. For exercise information preferences, a higher proportion of respondents preferred receiving information via technologically based approaches (i.e., Internet, CD-ROM, and mailed correspondence) compared with more traditional methods (i.e., mail or face-to-face counseling). Chi-square analyses revealed that a small number of exercise program and information preferences were modified by exercise, medical, and demographic variables.

CONCLUSIONS

Brain tumor patients may have unique and varied preferences compared with other cancer populations. Incorporating patient's preferences into rehabilitation programs and clinical exercise investigations may optimize the potential benefits of this modality for patients with neurologic malignancies.

Exercise Preferences of Endometrial Cancer Survivors

Exercise has gained recognition as an effective supportive care intervention for cancer survivors, yet participation rates are low. Knowledge of the specific exercise counseling and programming preferences of cancer survivors may be useful for designing effective interventions. In this study, we examined the exercise preferences of 386 endometrial cancer survivors. Participants completed a questionnaire that included measures of past exercise behavior, exercise preferences, and medical and demographic information. Some key findings were as follows: (a) 76.9% of participants said they were interested or might be interested in doing an exercise program and (b) 81.7% felt they were able or likely able to actually do an exercise program. Participants also indicated that walking was their preferred activity (68.6%) and moderate exercise was their preferred intensity (61.1%). Logistic regression analyses showed that meeting public health guidelines for exercise, being overweight or obese, receiving adjuvant treatment, months since diagnosis, income, marital status, and level of education all influenced exercise preferences. These results suggest that endometrial cancer survivors have unique exercise preferences that are moderated by a number of demographic and medical variables. These findings may have implications for the design and implementation of clinical and population-based exercise interventions for endometrial cancer survivors.

Patterns of exercise across the cancer trajectory in brain tumor patients

BACKGROUND

Exercise may represent a supportive intervention that may complement existing neurooncologic therapies and address a multitude of therapy-induced debilitating side effects in patients with brain tumors. Given the limited evidence, the authors conducted a survey to examine the exercise patterns of brain tumor patients across the cancer trajectory.

METHODS

Using a cross-sectional design, 386 brain tumor patients who received treatment at the Brain Tumor Center at Duke University were sent a questionnaire that assessed self-reported exercise behavior prior to diagnosis, during adjuvant therapy, and after the completion of therapy.

RESULTS

The response rate was 28% (106 of 383 patients). Descriptive analyses indicated that 42%, 38%, and 41% of participants, respectively, met national exercise prescription guidelines prior to diagnosis, during treatment, and after the completion of adjuvant therapy. Repeated measures analyses indicated no significant changes in the majority of exercise behavior outcomes over the cancer trajectory. However, exploratory analyses indicated that males and younger participants may be at the greatest risk of reducing exercise levels after a brain tumor diagnosis. These analyses remained unchanged after controlling for relevant demographic and medical covariates.

CONCLUSIONS

A relatively high percentage of brain tumor patients are exercising at recommended levels across the cancer trajectory. Moreover, these patients have unique exercise patterns that may be modified by select demographic variables. This preliminary study provides important informative data for future studies examining the potential role of exercise in patients diagnosed with neurologic malignancies.

Physical activity and quality of life in head and neck cancer survivors

PURPOSE

To examine the prevalence of exercise in head and neck cancer survivors and determine preliminary associations with quality of life (QoL), fatigue, and depression.

MATERIALS AND METHODS

Fifty-nine of 65 (91%) eligible head and neck cancer survivors recruited from an academic oncology clinic completed a self-administered survey including the modified Godin Leisure-Time Exercise Questionnaire and Functional Assessment of Cancer Therapy-Head & Neck (FACT-H&N), which includes physical, social, emotional and functional well-being (FWB) as well as additional concerns, and the FACT-General (FACT-G). Medical variables were obtained by medical record review.

RESULTS

The majority of participants were men (83%) and were Caucasian (92%), with mean age of 58+/-12.8. Cancer sites were primarily the oral cavity (24%), oropharynx (37%), or larynx (25%), with 20% being stage I, 7% stage II, 19% stage III, and 54% stage IV disease. Chemotherapy and/or radiation were ongoing in 14% of the participants. Half of the participants (51%) were diagnosed <6 months ago. Only three (5%) participants reported any vigorous exercise minutes (M=7.3+/-35.4), and only seven (12%) participants reported any moderate exercise minutes (M=19.5+/-70.6). Light exercise was reported by 26 (44%) (M=83.4+/-147.1). Only five (8.5%) participants were meeting current public health exercise guidelines. Partial correlations adjusting for age, medical comorbidity, and alcohol use showed that the total exercise minutes (i.e., light + moderate + vigorous) was positively associated with FWB (r=0.30, p=0.027), FACT-G (r=0.25, p=0.071), and FACT-H&N (r=0.26, p=0.064), was negatively associated with fatigue (r=-0.27, p=0.051), and had no association with depression (r=0.10, p=0.500).

CONCLUSIONS

Few head and neck cancer survivors are participating in any moderate or vigorous exercise, and over half are completely sedentary. Meaningful and potentially beneficial associations between total exercise minutes, QoL, and fatigue were demonstrated. An exercise intervention may have utility in this understudied cancer survivor group. Further research is warranted.