Date of Award
2024
Document Type
Thesis
Publisher
Edith Cowan University
Degree Name
Master of Medical and Health Science
School
School of Medical and Health Sciences
First Supervisor
Dr Favil Singh
Second Supervisor
Dr Caitlin Fox-Harding
Third Supervisor
Professor Dennis Taaffe
Fourth Supervisor
Professor Daniel Galvão
Fifth Supervisor
Professor Robert Newton
Abstract
Pregnancy-associated breast cancer (PABC) refers to breast cancer diagnosed during pregnancy or postpartum. Women with PABC experience symptoms such as nausea, pain, and fatigue during pregnancy and early motherhood, which can be barriers to exercise participation. Although exercise has numerous benefits for pregnancy and postpartum health, and can improve treatment-related symptoms, there is no research on exercise for PABC patients. Utilising a mixed-methods design, the aim of this body of research was to (1) assess the existing literature around PABC, treatment of the disease and current exercise recommendations for PABC patients through a narrative review, and to (2) identify exercise preferences, barriers, and facilitators among women with PABC through semi-structured interviews. Following interviews, an 8-week pilot exercise program was conducted to (3) assess its feasibility and effectiveness in improving physical function and better quality of life for women diagnosed with PABC. The review found that many studies highlight the benefits of exercising during breast cancer treatment in reducing symptoms, and some indicate that exercise can result in healthier, lower-risk pregnancies. However, there is no consensus on suitable exercise programs for this specific group. Considering the advantages of exercise for both breast cancer patients and pregnant/postpartum women separately, research focused on exercise programs tailored for this specific population is necessary. When recruitment for the interviews commenced, fifteen patients were contacted, and six completed interviews. Topics included exercise-related communication, exercise history, current physical activity, barriers, facilitators, and exercise preferences. Four categories emerged from the analysis: health and wellbeing, social factors, accessibility, and individual physical activity preferences. Facilitators included health benefits, social interaction, and access to various session delivery options. Barriers were related to childcare, domestic responsibilities, and fatigue. The exercise program (total of 16 sessions) had two of the six interview participants completed the exercise program. Participant A completed 17 sessions, and Participant B completed eight. No exercise-related adverse events occurred. Both participants improved physical function and quality of life. There was a range of exercise session adherence between the two participants (50-100%). Given the low engagement of pregnant and postpartum women in physical activity and the barriers, preferences and needs of women diagnosed with PABC, exercise programs should have a flexible delivery, higher intensity, and group sessions targeting younger women with cancer should be considered. The exercise program resulted in beneficial effects on quality of life and physical function, and participants reported a positive experience in engaging in the program. Study limitations include a lack of rural and ethnically diverse participants, small numbers and a bias sample, and no comparison groups in the exercise intervention. This study provides insights into the experiences, feasibility and preliminary efficacy of an exercise intervention for women with PABC, whilst accounting for common facilitators and barriers, although further research is required to confirm and expand these findings and to develop recommendations. Future research should develop and test exercise guidelines specifically for women with PABC, incorporating flexible program designs to help overcome barriers. Alternative methods for qualitative data collection, such as online questionnaires, could improve participation.
DOI
10.25958/950n-j655
Access Note
Access to this thesis is embargoed until 1 November 2026
Recommended Citation
Fleay, B. (2024). Exercise medicine in supportive care of pregnancy associated breast cancer: Feasibility and patient preferences. Edith Cowan University. https://doi.org/10.25958/950n-j655