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Exercise and diet show potential in improving outcomes in patients with ovarian cancer
Last reviewed: 02.07.2025
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A recent study published in the British Journal of Cancer assessed whether a combined exercise and dietary intervention program improved fatigue and physical function in patients with ovarian cancer.
Lifestyle Therapies 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).
Proper 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 cancer care guidelines.
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. The primary outcomes assessed included physical function, body composition, and fatigue, and secondary outcomes included HRQoL, physical fitness, anxiety, sleep disturbance, 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 old, had been diagnosed with primary epithelial ovarian cancer, and were scheduled to receive neoadjuvant chemotherapy. Individuals who had been diagnosed with ovarian cancer for more than five years and 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 the baseline questionnaire only.
The 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 skip follow-up visits than those who received adjuvant chemotherapy. Both groups demonstrated similar trajectories of increases in body composition and physical function, and reductions in fatigue.
The diagnosis of ovarian cancer at a late stage may be one of the reasons for the lack of difference in outcomes between the intervention and control groups. At a late stage, patients experience multiple syndromes, such as pain, which already affect their physical function and HRQoL at diagnosis. Surgery and chemotherapy can alleviate these symptoms and improve HRQoL.
Performance Analysis
Exploratory analysis shows that the effectiveness of a combined exercise and diet intervention depends significantly on the level of adherence to recommendations.
Strengths and Limitations
The main strength of the current study is its randomized controlled design. Another strength is that the intervention was developed based on current dietary guidelines, exercise principles, and Bandura's Social Cognitive Theory, all of which are recognized as important factors in improving health behavior in cancer patients.
The current study has some limitations, including the use of bioelectrical impedance analysis (BIA) instead of computed tomography (CT) to determine body composition. Furthermore, BIA 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 later stage in women aged 50 to 79. Therefore, screening for ovarian cancer in women in a younger age cohort may show fewer patients.