Cancer, Ovarian

Overview of Ovarian Cancer

This is the second most common form of cancer in females, with most developing from an epithelial tumor. Most ovarian tumors are not detected until they are in an advanced stage and have metastasized as they produce only vague and nonspecific symptoms. Treatment usually involves a total hysterectomy and lymphadendectomy followed with chemotherapy. Clients who participate in the recommended levels of physical activities experience fewer complications related to the treatment of ovarian cancer.¹ Clients become deconditioned due to the disease process and treatment programs that produce persistent fatigue and decreased tolerance to physical activities. Many clients who have been diagnosed with ovarian cancer are older, have a history of high dietary fat intake, and lead a sedentary lifestyle.²

Comorbidities to Consider

• Clients may have urinary incontinence and significant weight loss and may develop a cerebellar degeneration that results in ataxia, nystagmus, and dysarthria.

Client Examination

Keys to Examination of Clients

• Determine clients' physiologic status and preparedness for engaging in physical activities by assessing the blood tests for platelet, hemoglobin, and white blood cell levels. Clients undergoing chemotherapy may be advised by their oncologist not to participate in aerobic activities when hemoglobin levels are <10 g/mL and platelet counts are <50,000/mm³. Light exercise is permitted when platelet levels are between 20,000 and 30,000/mm³.

• Examine overall mobility as clients who have undergone surgical excisions and other procedures may have limited mobility due to slowed wound healing and fibrotic scar formations.

• Discuss with clients their potential barriers to engaging in regular exercise activities.²

Common Barriers for Engaging in Exercise Activities

Recommended Baseline Testing of Fitness Levels

• Use a walking test or a cycle ergometer test to assess clients' tolerance for exercise.

• Have clients perform tests for mobility and flexibility before beginning exercise activities.

• Quality-of-life measures and fatigue levels can be assessed with the Functional Assessment of Cancer Therapy for ovarian cancer.³

Exercise Prescription

Type: Walking, cycling, swimming⁴

Intensity: Start at 60% of predicted Vo₂ maximum

Duration: 15–20 minutes

Frequency: Three times per week

Getting Started

Develop with the client an abdominal and pelvic floor strengthening routine that is started preoperatively and maintained postoperatively.⁵ Exercise sessions can be used on days alternating with chemotherapy treatments. Resistance training can be combined with aerobic activities to improve muscle strength and improve quality of life. Progress aerobic activities to moderate intensities for 30 to ...