Exercise and diet show potential to improve outcomes in patients with ovarian cancer
Sist anmeldt: 14.06.2024
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A recent study published in the British Journal of Cancer assessed whether a combined program of exercise and dietary intervention improved fatigue and physical function in patients with ovarian cancer.
Lifestyle treatments for ovarian cancer
Ovarian cancer is one of the most common types of cancer in women. Because this type of cancer is usually diagnosed at a very late stage, the overall survival rate is low.
The usual treatment strategy for ovarian cancer involves cytoreductive surgery followed by chemotherapy. Following this treatment, patients often experience a variety of physical and psychosocial problems such as fatigue, decreased physical function, sarcopenia and malnutrition, which significantly reduce health-related quality of life (HRQoL).
Good nutrition and regular physical activity can significantly improve body composition, HRQoL, fitness levels and fatigue in cancer patients, which is why these strategies are included in international recommendations for the care of patients with cancer.
PADOVA Study
The Physical Activity and Dietary Intervention in OVArian cancer (PADOVA) study was conducted to evaluate the effectiveness of a combined exercise and diet intervention in patients with ovarian cancer receiving neoadjuvant chemotherapy. Primary outcomes assessed included physical function, body composition and fatigue, and secondary outcomes included HRQoL, physical fitness, anxiety, sleep disturbances and neuropathy symptoms.
The PADOVA study was a two-arm, multicenter randomized controlled trial (RCT) involving participants from three gynecologic oncology centers in the Netherlands. All study participants were over 18 years of age, had been diagnosed with primary epithelial ovarian cancer, and were scheduled to receive neoadjuvant chemotherapy. Individuals who were diagnosed with ovarian cancer more than five years ago and who were unable to perform basic daily tasks were excluded from the study.
Research results
There were no significant differences in physical function, body composition, or fatigue between the intervention and control groups. Eighty-one participants completed the study, and an additional 63 participants completed only the baseline questionnaire.
Mean age of participants was 59 years, and 60% of the cohort underwent primary surgery followed by adjuvant chemotherapy. There were no significant age differences between the intervention and control groups.
Patients who received neoadjuvant chemotherapy were more likely to refuse follow-up visits than those who received adjuvant chemotherapy. Both groups showed similar trajectories of increases in body composition and physical function, as well as decreases in fatigue.
The diagnosis of ovarian cancer at an advanced stage may be one of the reasons for the lack of differences in results between the intervention and control groups. In the advanced stage, patients experience multiple syndromes, such as pain, that already affect their physical function and HRQoL at diagnosis. Surgery and chemotherapy can alleviate these symptoms and improve HRQoL.
Efficiency analysis
Experimental analysis shows that the effectiveness of a combined exercise and diet intervention is significantly dependent on the level of adherence to recommendations.
Strengths and limitations
The main strength of the current study is its randomized controlled design. Another advantage is that the intervention was developed based on current dietary guidelines, exercise principles, and Bandura's Social Cognitive Theory, each of which has been recognized as an important factor in improving health behavior in cancer patients.
The current study has some limitations, including the use of bioimpedance analysis (BIA) instead of computed tomography (CT) to determine body composition. Moreover, the BIA method has limitations in patients with ascites, which may affect the accuracy of body composition measurements.
Unlike breast cancer patients, who are often diagnosed at an earlier stage, ovarian cancer is often diagnosed at a more advanced stage in women aged 50 to 79 years. Therefore, screening for ovarian cancer in women in a younger age cohort may show fewer patients.