Date of Award

Spring 5-28-2025

Document Type

Open Access Thesis

Degree Name

Master of Science (MS)

Department

Exercise and Health Science

First Advisor

Richard Viskochil

Second Advisor

Julie Wright

Third Advisor

Jessica Whiteley

Abstract

Abstract: Cancer is the leading cause of death among Americans under the age of 85 (Brown et al., 2012). There are increasing rates of cancer diagnoses in adults aged 18-49, which is described as an early onset (EO) diagnosis. Despite high survival rates (Lewis et al., 2021), EO cancer patients are at increased risk for long-term physical and psychological challenges associated with both the disease and its treatment (Haque et al., 2023). Cancer diagnosed during these critical periods of life can significantly impact self-perception and body image, which are critical to identity formation and quality of life (Castonguay, et al., 2017). Understanding the complex interaction between cancer and psychosocial factors in EO populations is essential to addressing the survivorship challenges that are unique to this population. In older adults, physical activity during and after cancer treatment has been associated with physiological benefits, including reduced risk of mortality, adverse effects, and cancer recurrence (Bélanger et al., 2011; Baumann et al., 2013; Cormie et al., 2017). There is also evidence to show that physical activity can improve body image, especially aspects that can be affected by cancer and its treatment, like physical body shape and perception (Dana et al., 2022, Mahdifar et al., 2021). However, this research remains less established in early onset cancer patients, highlighting the importance of this study.

Methods: This study is a secondary analysis from the Reproductive Health after Cancer Diagnosis and Treatment Study (REACT). REACT is a cross-sectional study of adults diagnosed with a first primary cancer between the ages of 18-49. It was a self-administered confidential questionnaire, that covered sociodemographic, cancer and cancer impact, reproductive health and fertility, sexual health and energy balance topics. Participants were recruited using methods such as community organizations, patient advocacy connections, survivorship groups, community newsletters and social media. Our secondary analysis examines the relationship between various sociodemographic factors—such as age, gender, origin of birth, , obesity status, and ethnicity—within the cohort and how these factors correlate with participants' self-reported physical activity levels and body image perceptions. This study uses a relatively novel approach by examining the relationship between distinct types and volumes of physical activity and self-perception tools in cancer patients. The ability to analyze these specific activity patterns alongside self-reported measures offers a unique and valuable perspective, contributing to a deeper understanding of how physical activity influences body image and psychological outcomes in this population.

We extracted this PA data from questions such as “In a typical week on how many days did you walk or cycle for at least 10 minutes to get to and from places?” and “How much time do you spend walking or cycling for travel on a typical day?”. From this raw data, we calculated the average time spent commuting by bike or foot by multiplying the days by time to get average minutes per week. We calculated this data for every type of PA, before using the quantifiable data to perform analyses.

Results: There were no significant differences in leisure time physical activity or total moderate and vigorous physical activity levels based on sex, age, race, country of origin, cancer type, treatment type, or active treatment. However, BMI was identified as a significant factor influencing both LTPA (p < 0.0001) and total MVPA levels (p = 0.0016). Higher levels of LTPA (p = 0.0013) and total MVPA (p = 0.0016) were associated with significantly more positive body image scores (BES), with this relationship being particularly strong in males engaging in higher levels of total MVPA. Additionally, obesity status was a significant factor, as higher BMI was consistently linked to lower BES scores across both sexes (p < 0.001).

Whilst Stunkard scores for body image perception were not significantly associated with total MVPA levels overall current (p = 0.485), diagnosis (p = 0.763) or ideal (p = 0.023), they were significantly different among females currently engaging in LTPA (p = 0.0002) and at diagnosis (p < 0.0001), with significant negative trends among females, and insignificant positive trends among the males. Additionally, obesity status had a strong impact on Stunkard scores, with higher BMI being consistently associated with greater body dissatisfaction across both sexes (all time points, p

Conclusion: Our findings reveal significant relationships between PA, obesity status, and body image perception in EO cancer patients, with notable sex differences. LTPA was strongly associated with improved body image, particularly in females, while total MVPA showed a weaker and less consistent relationship, especially in males. Higher BMI correlated with lower body image satisfaction across sexes, reinforcing these trends.

Comments

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