title: The prescription or proscription of exercise in endometrial cancer care.
abstract: OBJECTIVE
  To determine the proportion of endometrial cancer patients who can be safely prescribed community/home based unsupervised exercise. A better understanding of the physical dysfunction secondary to comorbidities among endometrial cancer patients would assist clinicians in delineating which patients to send to medically-based supervised rehabilitation versus a community/home based unsupervised exercise program.
  
  
  METHODS
  A literature review identified health issues which could impede patients from successfully completing an unsupervised exercise program after a cancer diagnosis. The charts of 479 endometrial cancer patients treated between 2006 and 2010 were reviewed to determine the health status at the time of diagnosis and the type and percentage of health-issues that could preclude an unsupervised exercise program in this population. Univariable modeling and multivariable modeling were used to evaluate the association of demographic, cancer-related characteristics and clinical variables with ability to participate in unsupervised exercise.
  
  
  RESULTS
  We determined that 14.2% of endometrial cancer patients were able to exercise without supervision based on their health status at the time of diagnosis. After excluding common comorbidities (hypertension, diabetes and morbid obesity) from the identified health-issues, the proportion increased to 20.5%. Older at diagnosis (P=0.007) and higher BMI (P<0.001) are more likely to exclude patients from community/home based unsupervised exercise program.
  
  
  CONCLUSIONS
  Only 14.2% to 20.5% of endometrial cancer patients were deemed able to exercise without supervision based on their health status at diagnosis. Our data suggest that approximately 80% of endometrial cancer patients would benefit from a referral to a medically-based supervised exercise program.
authors: Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Pennsylvania Perelman School of Medicine, United States; Center for Clinical Epidemiology & Biostatistics, University of Pennsylvania Perelman School of Medicine, United States.
authors: Xiaochen
authors: X
authors: Zhang
authors: Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Pennsylvania Perelman School of Medicine, United States.
authors: Ashley F
authors: AF
authors: Haggerty
authors: Center for Clinical Epidemiology & Biostatistics, University of Pennsylvania Perelman School of Medicine, United States.
authors: Justin C
authors: JC
authors: Brown
authors: Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Pennsylvania Perelman School of Medicine, United States.
authors: Robert
authors: R
authors: Giuntoli
authors: Department of Radiation Oncology, University of Pennsylvania Perelman School of Medicine, United States.
authors: Lilie
authors: L
authors: Lin
authors: Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Pennsylvania Perelman School of Medicine, United States.
authors: Fiona
authors: F
authors: Simpkins
authors: Center for Clinical Epidemiology & Biostatistics, University of Pennsylvania Perelman School of Medicine, United States.
authors: Lorraine T
authors: LT
authors: Dean
authors: Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Pennsylvania Perelman School of Medicine, United States.
authors: Emily
authors: E
authors: Ko
authors: Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Pennsylvania Perelman School of Medicine, United States.
authors: Mark A
authors: MA
authors: Morgan
authors: Center for Clinical Epidemiology & Biostatistics, University of Pennsylvania Perelman School of Medicine, United States. Electronic address: schmitz@mail.med.upenn.edu.
authors: Kathryn H
authors: KH
authors: Schmitz
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016889:Endometrial Neoplasms / Q000503:physiopathology* / Q000628:therapy*; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008875:Middle Aged; D012189:Retrospective Studies
keywords: Exercise prescription; Physical activity; Survivorship