The Swaying Pendulum: Factors Influencing Physical Activity Participation in Women With Recurrent Ovarian Cancer

Physical activity levels decline following diagnosis of ovarian cancer, and there is limited research investigating the factors that influence participation across the cancer continuum. The objective of this study is to explore barriers, facilitators, perceptions, and preferences of physical activity for women with recurrent ovarian cancer and to explore whether these factors change across the cancer continuum.

Women enrolled in the Exercise During Chemotherapy for Recurrent Ovarian Cancer trial were invited to participate. Semistructured interviews, guided by social cognitive theory, were conducted by 2 interviewers via video conferencing. All interviews were recorded and transcribed verbatim. Data were analyzed using an adaptive thematic approach.

An overarching theme, "The swaying pendulum," emerged following 13 participant interviews, representing the instability of physical activity participation in women with recurrent ovarian cancer. Five themes captured factors swaying the "pendulum": (1) the "priority ladder" of physical activity and the importance of social support and the physical environment, (2) the "hurdles" of treatment- and disease-related side effects, (3) the power of physical activity support and advice from health professionals in the face of uncertainty and fear, (4) a "yearning" for the outdoors, and (5) resorting to walking.

Physical activity participation in women with recurrent ovarian cancer is swayed by a complex combination of internal and external factors, unique to each individual, and continually changing circumstances across the cancer continuum.