Interactions between physical activity and type of cancer treatment received on associations with psychosocial outcomes among gynecologic cancer survivors

Objective. Physical activity is associated with improved cancer outcomes; however, it is unclear which pa-tients may benefit most from increased physical activity. We evaluated whether associations between meeting the American Cancer Society (ACS) physical activity recommendations and psychosocial outcomes in gyneco-logic cancer survivors varied by type of treatments received. Methods. We recruited English-speaking adult gynecologic cancer patients from an academic gynecologic on-cology practice to participate in a prospective cohort study. Participants completed a survey at study entry re-garding their psychosocial health-including distress, depression, anxiety, post-traumatic stress disorder, and quality of life (QoL)-and physical activity. Multivariate linear regression models for each psychosocial outcome tested for interactions between physical activity and each effect modifier (receipt of chemotherapy, radiation therapy, and/or minimally invasive surgery), adjusted for age, pain, body mass index, primary cancer diagnosis, cancer stage, time since diagnosis, and annual household income. Results. Among a total of 362 participants, 213 (59%) met ACS physical activity recommendations. We found evidence of interactions between physical activity and receipt of chemotherapy for depression, anxiety, and QoL scores; those who had received chemotherapy had a stronger association between physical activity and these psychosocial outcomes, compared to those who had not. We found no evidence of interactions between physical activity and receipt of radiation therapy or minimally invasive surgery for any of the outcomes. Conclusions. Gynecologic cancer survivors who received chemotherapy had significant associations between psychosocial health and physical activity, suggesting they may derive greatest benefit from prescribed exercise. (c) 2022 Elsevier Inc. All rights reserved.

Automated summary

This study examined the association between meeting the American Cancer Society's physical activity recommendations and psychosocial outcomes in gynecologic cancer survivors. The results showed that gynecologic cancer survivors who received chemotherapy had a stronger association between physical activity and depression, anxiety, and quality of life. No significant associations were found for those who received radiation therapy or minimally invasive surgery.