Introduction
Treatment-related adverse effects (AEs) are a common consequence of cancer therapies, with ovarian cancer treatment associated with severe toxicity. Exercise can mitigate treatment-related morbidity and improve quality of life. However, exercising while experiencing AEs is challenging. To support the integration of exercise into cancer care, healthcare professionals must understand the bi-directional relationship between treatment toxicities and exercise - AEs inform exercise prescription, and concurrently, exercise participation may influence AEs. The aim of this research was to describe the relationship between AEs and exercise by using data collected as part of the ECHO (Exercise during CHemotherapy for Ovarian cancer) trial.
Methods
The ECHO intervention involves the addition of exercise therapy (target dosage 150 minutes, moderate-intensity, multi-modal exercise/week; average intervention duration: 18 weeks) to first-line chemotherapy for ovarian cancer. Study-trained exercise professionals prompted exercise group participants (n=187) to self-report AEs during weekly telephone sessions. Frequencies of AEs by subgroups (e.g., grade, causality, impact on exercise prescription) were recorded and assessed. Case studies were developed from case notes to provide contextualised examples of the inter-relationship between exercise and AEs.
Results
An average of 25 (min: 2; max: 87) AEs (98% grade 1-2) per person were recorded throughout the intervention period. Of these, the minority (5%) were exacerbated by exercise (most common: fatigue, dyspnoea, pain), and only 7% required subsequent exercise prescription modification or interruption to exercise. Examples of cases whereby exercise improved AEs, as well as when AEs were exacerbated by exercise, and subsequent changes to exercise prescription will be described during the presentation.
Conclusions
These findings highlight that AEs during chemotherapy for ovarian cancer are common and that exercise prescription during this period requires advanced clinical judgment and regular communication between the patient and their allied health professionals.