It’s no mystery why people might find it difficult to begin or keep up an exercise routine after a diagnosis of ovarian cancer.
Cancer treatment in general can lead to less physical activity because of nausea and discomfort, poor appetite, and fatigue. With ovarian cancer, there often are added challenges. These include dealing with the sudden onset of menopause for some people. There can be limits on physical activity after abdominal procedures known as primary cytoreductive surgery and debulking. Both of these operations involve removing as much cancerous tissue as possible.
Energy Levels Can Drop, but Exercise Is Still Important
Research has proven what many people know from personal experience about how activity levels can slip during ovarian cancer treatment.
A 2022 Danish study of women with ovarian cancer who were having chemotherapy, for example, found the percentage of participants who regularly exercised for 3 or more hours a week dropped from 65% before diagnosis to 41% after diagnosis. And the percentage of people in the study who were sedentary (no exercise) grew from 4% to 18%.
Many studies also have shown that overcoming these challenges to start or keep up your exercise plan can pay off in better quality of life, improved mental health, and even less fatigue.
Prue Cormie, PhD, a physiologist who is the founder of the Australian nonprofit EX-MED Cancer, says in a webinar called “Exercise and Cancer” that exercise should be included in treatment plans for people with cancer. “If the effects of exercise could be encapsulated into a pill, it would be demanded by every single cancer patient. It would be prescribed by every single cancer doctor,” Cormie says.
The hitch, though, is that finding time and motivation for activities like walking and yoga – especially when facing fatigue and other complications of cancer treatment – is not as easy as popping a pill. “The sad fact is that we can’t just ‘take’ exercise,” Cormie says. “We have to do exercise.”
Of course, you need to check with your doctor about choosing exercises and the intensity of your workout plans.
Some studies have shown exercise can boost the activity of parts of the immune system that target cancer. Previous research on this question had mixed results.
Exercise Should Fit Your Needs
A study in South Korea looked at results of a small supervised exercise program for women after surgery for ovarian cancer. Some women attended the exercise program at the hospital, doing aerobics as well as walking, and even eventually doing light jogging. Others did not exercise. Researchers found that the body weight and fat mass of the exercise group dropped by more than 5%, while it rose 4.6% for the group that didn’t exercise. They also said they found evidence that exercise could boost parts of the immune system linked to fight the survival and spread of tumors. This is a small study, but the finding is consistent with other research that has linked exercise to better immune response in people who have cancer.
The exercise program in this study was adapted for each person’s needs. For instance, women whose cancer had spread to bones were told to avoid resistance training with heavy weights.
Heather Leach, PhD, a Colorado State University researcher who runs the Fitness Therapy for Cancer Program (FIT Cancer), also emphasizes the need to tailor exercise to people’s needs. In a recorded session from the 2021 Ovarian Cancer Research Alliance national meeting, she says it’s OK to ease back a bit on exercise temporarily if your fatigue increases.
Jocelyn Chapman, MD, a gynecologic cancer surgeon and assistant professor of gynecologic oncology at the University of California, San Francisco, says exercises that target abdominal muscles should be avoided as you’re recovering from surgery. But Chapman says she encourages women fighting ovarian cancer to continue to be active because exercise can help them manage the stresses involved with a cancer diagnosis. “Exercise is an important part of healing and although patients might feel weakened, I do encourage them to start back slowly into an exercise routine,” Chapman says.
The American College of Sports Medicine (ACSM) says people with cancer should take realistic steps toward boosting their physical activity. Start with simple steps, such as a few laps around the kitchen table, walking your dog, or walking to the mailbox. The group gives the advice: “Start where you are. Use what you have. Do what you can.”
ACSM recommends asking your doctor about limitations you may face because of your treatments, medications, and complications.
In addition, the ACSM says you have to take into account side effects from cancer treatment and how they might affect your ability to exercise. If you have an increased risk for infections, for example, you may want to avoid swimming pools. If you have peripheral neuropathy you should be careful walking on treadmills and use handrails.
The ACSM also recommends finding a buddy to make exercise more fun.
Walking Is Just One Helpful Exercise
Walking is a go-to component of most exercise programs. There are other options, too, after an ovarian cancer diagnosis:
- Tai chi. This offers a combination of benefits for the mind and body. It involves many slow deliberate movements. These movements can provide a gentle way to tone muscles, focus on breathing and posture, and reduce stress. Tai chi evolved from an ancient Chinese martial art. It uses a focal point for meditation just below the navel. The idea is that from that focal point “chi” – a vital energy or life force – flows throughout the body.
- Yoga. There are many different kinds of yoga, but they share basic features: physical movement, breathing exercises, and meditation to make a connection between the mind, body, and spirit. An average yoga session may last between 20 minutes and 1 hour. You can practice yoga at home without an instructor. But if you’re new to it, you can start with classes at a yoga center, community center, or health club.
- Water activities. Swimming and water exercise classes are gentle, low-impact exercises you can do as you’re recovering. Just make sure you don’t have any kind of skin irritation or sores when you get in the pool. And to be on the safe side, rinse off when you get out.
For most women, walking and simple aerobics are enough. Dmitriy Zamarin, MD, PhD, a medical oncologist at Memorial Sloan Kettering Cancer Center, says he will recommend weight-bearing exercises that can reduce the risk of osteoporosis. But he cautions, "Before initiation of weight-bearing exercises I typically recommend for the patients to discuss with their surgeons to ensure that their wounds have healed and that weight-bearing exercises would not predispose them to development of hernia."
Zamarian also says jogging, running, and biking are excellent options. Plus, these exercises can have a positive impact on cardiovascular health.