Oral Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2024

Are our exercise oncology guidelines fit-for-purpose for women with recurrent ovarian cancer? Results from a mixed methods exercise trial (the ECHO-R trial) (#87)

Sandi Hayes 1 , Monika Janda 2 , Elizabeth Eakin 3 , Catherine Shannon 4 , Jeffrey Goh 4 , Vanessa Beesley 5 , Dimitrios Vagenas 6 , Penny Webb 5 , Jermaine Coward 7 , Louisa Collins 5 , Helene O'Neill 4 , Sheree Rye 1 , Melissa Newton 1 , Gabrielle Gildea 8 , Melanie Plinsinga 8 , Carolina Sandler 9 , Tamara Jones 10 , Sara Baniahmadi 4 , Marcelo Nascimento 11 , James Nicklin 12 , Andrea Garret 4 , Andreas Obermair 4 , Rosa Spence 1
  1. Cancer Council Queensland, Brisbane, QLD
  2. Centre for Health Services Research, University of Queensland, Brisbane, QLD
  3. Faculty of Medicine, School of Public Health, The University of Queensland, Brisbane, QLD
  4. Queensland Centre for Gynaecological Cancer Research, The University of Queensland, Herston, QLD
  5. Population Health Program, QIMR Berghofer Medical Research Institute, Brisbane, QLD
  6. School of Public Health and Social Work, Queensland University of Technology Faculty of Health, Kelvin Grove, QLD
  7. Faculty of Medicine and ICON Cancer Care Centre, The University of Queensland, Brisbane, QLD
  8. School and Health Sciences and Social Work, Menzies Health Institute Queensland, Griffith University, Brisbane and Gold Coast, QLD
  9. Sport and Exercise Science, School of Health Science, Western Sydney University, Sydney, NSW
  10. Melbourne School of Psychological Sciences, Faculty of Medicine, Dentistry, and Health Sciences, University of Melbourne, Melbourne, Vic
  11. Gold Coast University Hospital, Southport, QLD
  12. Gynaecological Cancer, Royal Brisbane and Women's Hospital, Herston, QLD

Background and aims:

People with rare cancers, lower survival prospects, and higher morbidity have been under-represented in exercise oncology trials. The ECHO-R trial evaluates the safety, feasibility and potential efficacy of a pragmatic, telehealth-delivered exercise program in the understudied population of recurrent ovarian cancer patients.


Methods:

50 women receiving chemotherapy for recurrent ovarian cancer were recruited to this pre-post, mixed-method exercise trial. The six-month intervention was delivered by Exercise Professionals via 12 telephone sessions and up to five in-person sessions. The weekly exercise intervention target was consistent with exercise oncology guidelines - 150 minutes of moderate-intensity, multimodal exercise - with prescribed volume and mode individualised. Primary outcomes were feasibility (minutes of exercise completed) and harms profile (exercise-related adverse outcomes) of the intervention. Secondary outcomes, assessed at baseline and post-intervention, included quality of life (FACT-O), fatigue (FACT-Fatigue), anxiety and depression (HADS), and neurotoxicity (FACT-GOG-NTX). 13 women participated in post-intervention qualitative interviews to provide a deeper understanding of factors influencing exercise participation. 


Results:

The average minutes of weekly exercise completed did not meet the target (median 142 min/week, min: 0; max 533). 38% of the sample reported ≥1 harm (range 0-7 harms/person; no serious harms reported), with 71% of harms impacting exercise participation (11% moderate-major impact). There was no meaningful change in health outcomes observed between pre- and post-intervention. The importance of social support and the physical environment, the “hurdles” of side effects, the power of advice from health professionals, a “yearning” for the outdoors and a tendency to “resort” to walking emerged as qualitative themes influencing physical activity participation.


Conclusion: 

Findings support that those delivering exercise therapy to people with recurrent ovarian cancer should focus on each person’s “why” and that factors influencing exercise participation may be more psychosocial than physical.