# The Effect of Lifestyle on the Quality of Life of Vulvar Cancer Survivors

## TL;DR

This study shows that being physically active improves the quality of life for women who have survived vulvar cancer, while BMI does not have a significant impact.

## Contribution

The study identifies physical activity as a key modifiable factor influencing quality of life in vulvar cancer survivors.

## Key findings

- Higher physical activity levels correlate with better overall quality of life in vulvar cancer survivors.
- BMI was not found to be associated with quality of life outcomes in these survivors.

## Abstract

Vulvar cancer affects approximately 47,000 women per year worldwide. As treatment options have improved, the number of survivors is increasing, and with that, the focus on their quality of life. This study evaluated the effect of physical activity and body mass index (BMI) on the quality of life of vulvar cancer survivors. Women who had been treated with surgery for vulvar cancer stage IB or higher were asked to participate. We found that a better physical activity level was associated with a better quality of life. Interestingly, BMI was not associated with the quality of life of survivors. We, therefore, conclude that more attention needs to be given to the role of physical activity during the survivorship era of vulvar cancer patients to improve their quality of life.

Introduction: Vulvar cancer affects approximately 47,000 women annually worldwide. With most studies focusing on oncological outcomes, quality of life is often overlooked. There is a lack of knowledge on the influence of modifiable factors such as lifestyle on the quality of life of vulvar cancer survivors. This study evaluated the association between lifestyle factors and the quality of life of vulvar cancer survivors. Methods: This was a cross-sectional survey study of women who received surgical treatment for vulvar cancer ≥FIGO stage 1B at the Northern Gynecological Oncology Centre, UK, between 2013 and 2022. Baseline and clinical characteristics were collected from patient records. Godin Leisure-Time Exercise questionnaires were used to assess physical activity. BMI was assessed using self-reported height and weight. Quality of life was measured using the validated European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC QLQ-C30) and the vulvar cancer-specific module (VU-34). An analysis was performed using Mann–Whitney-U and Kruskal–Wallis tests. Results: Of the 299 women, 139 were eligible for participation, of whom 58 participated (41.7%). Twenty participants had a sedentary (40.8%), eight a moderately active (16.3%), and seventeen an active (34.7%) lifestyle. Active participants reported higher overall quality of life and higher functioning in all domains but not for vulvar-related symptoms or sexual functioning. Forty-nine participants disclosed their BMI, which was not associated with quality of life outcomes. Conclusions: A higher level of physical activity was associated with higher quality of life. No association was found between BMI and quality of life.