The associations between physical activity, neuropathy symptoms and health-related quality of life among gynecologic cancer survivors

Objective: Physical activity may mitigate the effects of cancer treatment. We sought to evaluate the association between self-reported physical activity, neuropathy symptomatology, and emotional health in gynecologic cancer survivors. Methods: Patients were recruited from an academic gynecologic oncology practice to a prospective cohort study. Participants completed semiannual surveys on quality of life (QOL), neuropathy symptoms, depression, distress, and health behaviors. Abstracted clinical data included cancer type, FIGO stage at diagnosis and treatments received (chemotherapy, surgery, radiation). Physical activity [no: moderate physical activity <150 min/week, yes: ≥150 min/week] and neuropathy symptomatology [high (FACT/GOG-Ntx ≥11; upper quartile); low (<11)] were dichotomized. Linear regression models assessed the associations between physical activity, neuropathy and psychosocial outcomes. Results: A total of 194 participants were included in this analysis. We identified significant interactions between physical activity and neuropathy in the depression (p = 0.0006) and QOL (p = 0.007) models. Greater physical activity and lower neuropathy scores were independently associated with fewer depressive symptoms (p = 0.02 and p < 0.0001, respectively) and greater QOL (p = 0.005 and p < 0.0001). Low neuropathy scores were associated with lower distress (p < 0.0001). Women with high neuropathy scores had larger beneficial associations between being physically active and depression and QOL. In the distress model, interaction between neuropathy and physical activity was suggested (p = 0.05). Conclusions: Physical activity was associated with favorable psychosocial outcomes in gynecologic cancer survivors, most notably among those with worse neuropathy. These data suggest prescriptive exercise should be evaluated as a means of mitigating cancer-associated neuropathies and their effect on emotional health.