A man who has learned how to die has unlearned how to be a slave (Montaigne)

 If you are by chance in Berlin on 25.7. you can join me for a reading event on Medicine, Arts and Culture:

Pressemitteilung der Universität Erfurt: "Nicht alle Tage" - Roman von Markus Vinzent

Hier die Pressemitteilung von heute, dem Tag der Veröffentlichung von: Nicht alle Tage

"Letting go", Part One, Chapter Three ('Bruno and Anika'), sub-chapter two: Challenges for Anika

 Please join me on the next sub-chapter of the forthcoming novel "Letting go", Part One, Chapter Three ('Bruno and Anika'), sub-chapter two: Challenges for Anika

https://youtube.com/live/9a74anBWEvc?feature=share

Letting go - Part One Chapter Three ('Bruno and Anika'), sub-chapter one: In paradise (Saarland)

 Here comes the first sub-chapter of chapter three ('Bruno and Anika') of my forthcoming novel 'Letting go': I 3.1. In paradise (Saarland).

The novel will be published in German (title: "Nicht alle Tage") and potentially later in English. The book tells the story of two couples and their intricate relations. When Feeny, one of the two ladies, is diagnosed with a chronic illness, all relations change. Letting go is about learning how to live the now.

"Letting go is a great novel about hidden facets of a relation between yourself and people that you care for"

(Univ.-Prof. Dr. med. Jalid Sehouli, director of the gynecological clinic and tumor centre, Charité, Berlin).

"This novel brings out the importance of the relationship between patient and doctor. It is written from the heart having experienced turbulent but precious times caring for a loved one with cancer." (Prof Jonathan A Lederman, MD FRCP FMedSci, Professor of Medical Oncology, Clinical Director, UCL Cancer Institute, London)

"Written with a light hand it guides into the depth of risky relations, precarious situations and an adventorous journeys. With unusual humor the author describes a longlasting illness. History and geography extend in narration and grow into a European dimension of a liberated experience of the world" (Prof. Dr. Dietmar Mieth, em. Professor for theological ethics, University of Tubingen; founder of the European Society of Catholic Theology; author of "Ketzerflammen in Paris", 2024).

The first vol. will be published before Christmas with Verlag Der Blaue Reiter, Göttingen. Please pre-order the German book (Vol I and II, each ca. EUR 29): info@verlag-derblauereiter.de copyright: Verlag der Blaue Reiter, Göttingen

Letting go - the next sub-chapter of the forthcoming novel: Feeny in panic

Here comes the next sub-chapter of chapter two ('Feeny') of my forthcoming novel 'Letting go': I 2.7. Feeny in panic.

The novel will be published in German (title: "Nicht alle Tage") and potentially later in English.

The book tells the story of two couples and their intricate relations. When Feeny, one of the two ladies, is diagnosed with a chronic illness, all relations change. Letting go is about learning how to live the now.

The first vol. will be published before Christmas with Verlag Der Blaue Reiter, Göttingen.

Please pre-order the German book (Vol I and II, each ca. EUR 29): info@verlag-derblauereiter.de

copyright: Verlag der Blaue Reiter, Göttingen

Letting Go - the next sub-chapter: Bald head

 Please do join me on the next sub-chapter of chapter two ('Feeny') of my forthcoming novel 'Letting go': I 2.6. Bald head.

The novel is going to be published in German (title: "Nicht alle Tage") and potentially later in English.

The book tells the story of two couples and their intricate relations. When Feeny, one of the two ladies, is diagnosed with a chronic illness, all relations change. Letting go is about learning how to live the now.

The first vol. will be published before Christmas with Verlag Der Blaue Reiter, Göttingen.
Please pre-order the German book (Vol I and II, each ca. EUR 29): info@verlag-derblauereiter.de

https://youtube.com/live/-oYTf5CWS98?feature=share

The next episode of "Letting go", I 2.2: Anika and Feeny again

 after a few weeks interruption because of conferences, here the next sub-chapter of my forthcoming novel "Letting Go": I 2.2 "Anika and Feeny again". You can join me live in a few minutes or watch the episode later on:

https://youtube.com/live/7hfePO3DsDY?feature=share

The novel is going to be published in German first with the titel: "Nicht alle Tage" and potentially later in English.
The book tells the story of two couples and their intricate relations. When Feeny, one of the two ladies, is diagnosed with a chronic illness, all relations change. Letting go is about learning how to live the now.

The book (vol I) will be out before Christmas (Verlag: Der Blaue Reiter, Göttingen).
To pre-order the German book (Vol I and II, each ca. EUR 29): info@verlag-derblauereiter.de

Letting go - chapter 2 sub-chapter 4: Rhythm

 Join me on the next sub-chapter of my novel "Letting go", I 2.4: Rhythm, simply follow this link in a few minutes: https://youtube.com/live/d4g8ZcvEaxs?feature=share

Here comes the next sub-chapter of chapter two ('Feeny') of my forthcoming novel 'Letting go': I 2.4. Rhythm
The novel is going to be published in German and potentially later in English.
The book tells the story of two couples and their intricate relations. When Feeny, one of the two ladies, is diagnosed with a chronic illness, all relations change. Letting go is about learning how to live the now.

In a few weeks, the novel will be published, first in German (Verlag: Der Blaue Reiter, Göttingen).
To pre-order the German book (Vol I and II, each ca. EUR 29): info@verlag-derblauereiter.de

"Mind the gap" - the next sub-chapter (3) of chapter 2 of my novel "Letting go"

 Before getting the next episode of my novel, perhaps you can help me - the German publisher has asked me for a more appealing title, as he thinks "Loslassen" would be not attractive enough. If you have a good suggestion, please let me know. For most of my books, others have created the titles, for which I am most grateful.

Now, here the link to the next episode (in a few minutes live): chapter 2, sub-chapter 3: Mind the gap

https://youtube.com/live/YXDhjyOLVm4?feature=share

The novel is going to be published in German and potentially later in English.
The book tells the story of two couples and their intricate relations. When Feeny, one of the two ladies, is diagnosed with a chronic illness, all relations change. Letting go is about learning how to live the now.

In a few weeks, the novel will be published, first in German (Verlag: Der Blaue Reiter, Göttingen).
To pre-order the German book (Vol I and II, each ca. EUR 29): info@verlag-derblauereiter.de

The next chapter,

 Please join me on the next episode, sub-chapter two of chapter 2 of my novel "Letting go", coming up in a few minutes here:

https://youtube.com/live/EvbbpaGnFUA?feature=share

Here comes the first sub-chapter of chapter two ('Feeny') of my forthcoming novel 'Letting go': I 2.2. All the best, Feeny.
The novel is going to be published in German and potentially later in English.
The book tells the story of two couples and their intricate relations. When Feeny, one of the two ladies, is diagnosed with a chronic illness, all relations change. Letting go is about learning how to live the now.

In a few weeks, the novel will be published, first in German (Verlag: Der Blaue Reiter, Göttingen).
To pre-order the German book (Vol I and II, each ca. EUR 29): info@verlag-derblauereiter.de

Letting go - the first sub-chapter (it dawns) of chapter 2 (Feeny)

to join me (again) for the next episode, sub-chapter one: It dawns of chapter 2 ('Feeny') of the forthcoming novel "Letting go"

The novel is going to be published in German and potentially later in English.

The book tells the story of two couples and their intricate relations. When Feeny, one of the two ladies, is diagnosed with a chronic illness, all relations change. Letting go is about learning how to live the now...

here the link for the new episode of Letting go - Part One Chapter Two ('Feeny'), sub-chapter one: It dawns

https://youtube.com/live/8JKDHRP2rMY?feature=share

"Letting go" - all sub-chapters of the first chapter

 Here is the playlist with all four sub-chapters of the first chapter of my novel "Letting go":

https://www.youtube.com/playlist?list=PL1qQuFYfwxOmvMskpI4xEnJDxy08UJp12

Fourth sub-chapter of chapter one: Shadow of light of my new novel "Letting go"

 If you wish to join me, please click

 

 

The novel is going to be published in German and potentially later in English. The book tells the story of two couples and their intricate relations. When Feeny, one of the two ladies, is diagnosed with a chronic illness, all relations change. Letting go is about learning how to live the now. In a few weeks, the novel will be published, first in German (Verlag: Der Blaue Reiter, Göttingen). To pre-order the German book (Vol I and II, each ca. EUR 29): info@verlag-derblauereiter.de

Letting go - the third sub-chapter: Shake history off

 You are invited to another live-stream for the third sub-chapter of my forthcoming novel 'Letting go', I 1.3: Shake history off.

If you like, join me in a few minutes, or watch it later at: https://youtube.com/live/XxBoBaTVfFk?feature=share

The novel is going to be published in German and potentially later in English.

The book tells the story of two couples and their intricate relations. When Feeny, one of the two ladies, is diagnosed with a chronic illness, all relations change. Letting go is about learning to live the now.

In a few weeks, the novel will be published, first in German (Verlag: Der Blaue Reiter, Göttingen).

To pre-order the German book (Vol I and II, each ca. EUR 29): info@verlag-derblauereiter.de

Letting go - the next sub-chapter of my forthcoming novel: I 1.2 Vacation in Crete

 If you like to listen to the next sub-chapter of my forthcoming novel 'Letting go', please join me in a few minutes: 

The novel is going to be published in German and potentially later in English.

The book tells the story of two couples and their intricate relations. When Feeny, one of the two ladies, is diagnosed with a chronic illness, all relations change. Letting go is about learning to live the now.

In a few weeks, the novel will be published, first in German (Verlag: Der Blaue Reiter, Göttingen).

To pre-order the German book (Vol I and II, each ca. EUR 29): info@verlag-derblauereiter.de

Letting go - Loslassen: My novel on relationship and the art of detachment

Bringing Eckhart as a Lebemeister (a master of how to live) into the 21st century, I wrote a novel, Letting go, or in German: Loslassen.

The novel which shares some elements (length and topics) with Thomas Mann's Zauberberg (had I only the skills of this author!) deals with two couples and their intricate relationships. The novel is also about challenges like misuse in the church, questions of relations (LGBT) and others.

One Feeny, one of the ladies in the book, is diagnosed with a chronic disease, the relations change again.

To watch and listen to the opening, join me here: https://www.youtube.com/live/Daf3_IElJYY

In a few weeks, the novel will be published, first in German (Verlag: Der Blaue Reiter, Göttingen). 

To pre-order the German book (ca. EUR 29): info@verlag-derblauereiter.de

What should cancer patients eat during Taxol (paclitaxel) chemotherapy?

Nothing spectacular for those who have experience with eating diets for cancer patients, but I think the following information summarises well the latest information on what to prefer and what to leave during Taxol (paclitaxel) chemotherapy in ovarian cancer:

Taxol (paclitaxel) is effective in improving breast cancer prognosis: numerous studies have found that it protects against breast cancer recurrence and death. Taxol and other taxanes can result in side effects such as hair loss, mouth sores, nausea, fatigue, low white blood cell count, neuropathy, muscle and joint pain, cognitive impairment (chemo brain) and serious infections. While obtaining relief from these side effects obviously is desirable, it is very important for breast cancer patients to avoid consuming foods or taking supplements that will lessen the cytotoxic impact of chemotherapy on cancer cells.

While various micronutrients found in fruits, vegetables and other foods have been shown to help protect against breast cancer development and metastasis, some of the same micronutrients might enable breast cancer cells to survive chemotherapy. Therefore, the strategy we recommend during chemotherapy and for the following month is to consume the foods recommended below, as well as those listed on the bland chemotherapy diet (also below), while limiting or avoiding the foods listed below that should not be consumed while on Taxol (as well as those on our avoid list). Please see also our web page on factors influencing Taxol's effectiveness.

Foods that enhance the effectiveness of Taxol

The following foods are very good sources of compounds that have been shown to increase the anti-cancer effects of Taxol:

Apples

Artichokes

Arugula

Basil

Bell peppers

Black pepper

Blueberries

Bok choy, or Chinese cabbage

Brazil nuts

Broccoli

Brussels sprouts

Cabbage

Carrots

Cauliflower

Celery

Collard greens

Cranberries

Garlic

Ginger

Grape juice, purple

Grapes, red

Greens

Hot peppers

Kale

Leeks

Mustard

Olives and olive oil

Onions, yellow

Parsley

Rice, brown

Salmon, wild

Seaweed

Spinach

Tomatoes

Turmeric

Turnips and turnip greens

Watercress

Watermelon

Many women undergoing chemotherapy develop abnormally low iron levels, which must be treated. However, excess iron is also to be avoided during chemotherapy. Curcumin (found in turmeric) has been shown to be an iron chelator, a compound that removes iron from the body. Turmeric might also protect the brain from chemotherapy, thereby possibly reducing chemo brain.

Sour cherries, olive oil and vitamin D might relieve joint and muscle pain, although their effectiveness has not specifically been studied in the context of taxane chemotherapy. Brazil nut consumption should be limited to no more than one nut per day, on average, to avoid consuming excess selenium.

Please note that while salmon and the closely-related Arctic char are recommended for consumption during Taxol chemotherapy, recent research suggests that herring, sardines, anchovies, mackerel, lake trout and similar fish should not be consumed the day before through the day after a chemotherapy treatment. In addition, these fish should be consumed only in moderation during the remaining days of each cycle. Fish oil supplements should not be consumed by those undergoing chemotherapy.

Foods and other products that should not be used during Taxol chemotherapy:

The following foods and supplements have been found either to interfere with the effectiveness of Taxol or, in the case of raw shellfish, should not be consumed by those with impaired immunity:

Açaí berries

Caffeine, any source

Caviar

Coffee, regular or decaf

Fish oil

Grapefruit

Hormone replacement therapy, including bioidentical or natural hormones

Iron supplements (unless medically necessary)

Mint tea

Multivitamins & antioxidant supplements

Saffron

Sage

Shellfish, raw

Acetyl-l-carnitine, which is sometimes used for the prevention of taxane-induced neuropathy, has been found actually to increase neuropathy.

Citrus flavonoid hesperidin could reduce effectiveness of cyclophosphamide

Hesperidin, a flavonoid found in oranges, tangerines, kumquats, lemons, limes and grapefruit, has the potential to interfere with chemotherapy regimens containing cyclophosphamide, such as TAC (taxotere, adriamycin and cyclophosphamide). Cyclophosphamide is an alkylating agent frequently used in combination with taxanes (Taxol, Taxotere) and/or anthracyclines (Adriamycin, epirubicin) to treat breast cancer. Hesperidin is found most abundantly in the peel, pith and membranous parts of oranges and other citrus fruits. Prepared food sources include orange tea, unfiltered orange juice, orange marmalade, and dishes that incorporate citrus peel such as Szechuan Orange Chicken.

Bland diet for use during Taxol chemotherapy

The list below features bland, as well as somewhat bitter-tasting foods, that do not promote cancer (when consumed in moderation). It is important not to drive up blood sugar and insulin levels with high carbohydrate/low fiber meals. Select as wide a variety of these foods as possible and consume any one of them in moderation in addition to the foods recommended above.

Almonds, skinless

Bananas

Beans, white

Bread, whole grain

Chicken, organic

Coconut, raw

Cucumbers

Green beans

Honey, minimally processed

Lettuce, iceberg

Melons, pale winter

Onions, Vidalia

Peaches, white

Pears

Peas

Potatoes

Rice

Turkey, organic

Vinegar, white

Yogurt, low-fat

Zucchini

Weight loss and weight gain during chemotherapy

Recent studies suggest that fasting around chemotherapy treatments could protect normal cells from the toxic effects of chemotherapy while sensitizing cancer cells to the treatment. However, more studies and human trials are required before it can be determined whether fasting during chemotherapy is safe and effective.

On the other hand, weight gain, which is common during chemotherapy, is known to be associated with less favourable prognosis and should be avoided.

 

Unfortunately no specific webpage exists so far for food and diet in ovarian cancer cases, so the occasional posts here may make a start of what has already been well developed in the field of breast cancer research: http://foodforbreastcancer.com/articles/what-should-breast-cancer-patients-eat-during-taxol-(paclitaxel)-chemotherapy%3F

On side-effects of chemotherapy, see the informative diagram and commentary of Healthline.

Higher Chances of Surviving Ovarian Cancer through the right Diet and Physical Activity: New Research

In a previous blog, 4 years ago, I gathered medical reports about forms of diet that recognised medical studies have suggested to have an impact on the survival rate and length of Ovarian Cancer patients. Having done some further research on this topic, I am not suggesting to reject or even replace standard medical treatments, as some do, although elements of what, for example, cancer survivors like journalist and media entrepreneur Evita Ramparte live on are certainly reflective of medical studies (emphasising fresh, organic fruit and vegetables, less red meat etc.). While a positive attitude, not to focus on the cancer, but rather on the rebalancing of one's own life seems vital, one of the important suggestions which seem shared by medical studies is the impact of sports.

In an important study and report on ‘nutrition during and after Cancer therapy’, Stephanie Barrera and Wendy Demark-Wahnefried published in Oncology (Williston Park) 23 (2009 Feb) (2 Suppl): 15–21, found out that ‘diet and nutritional factors play a large role in influencing both the quality and quantity of life after the diagnosis of cancer. The oncology nurse is well-positioned to: 1) oversee that the nutritional needs of patients who are newly-diagnosed, undergoing active treatment, or those with advanced disease are met; 2) facilitate referrals of patients with more intensive nutritional needs to registered dietitians; and 3) promote the importance of weight management and a healthful plant-based diet, low in saturated fat and simple sugars, and high in fruits and vegetables and unrefined whole grains, to patients who are likely to join the ranks of ever-expanding population of cancer survivors who now constitute roughly 4% of the U.S. population and who number over 11 million’. In more detail, they show that ‘Current guidelines advocate a modest rate of weight loss (no more than two pounds per week) during the time of treatment among patients who are overweight or obese, as long as it meets with oncologist approval. Guidelines established for weight management in the general population should be applied to cancer survivors, and should include not only caloric restriction and increased energy expenditure through exercise, but also behavior therapy. While modest rates of weight loss can be achieved by portion control and by substituting low-energy density foods (e.g., water-rich vegetables, fruits, whole grains, and broth-based soups) for foods that are higher in calories, more structured and intensive programs that include exercise and promote energy deficits of up to 1,000 calories/day may yield better results. Previous studies have found exercise to be a strong predictor of weight loss among cancer survivors. Accumulating evidence also suggests that physical activity may independently affect the course of colorectal and breast cancer, and also affects the risk of secondary cancers at each of these sites, as well as for endometrial cancers.’

One note on Green tea during a therapy with Bortezomib: A study of 2009 found out that patients during this therapy should not dring Green tea because its content (EGCG) could counter-act the therapy - but they can start drinking Green tea again, once the therapy has ended (see N. Quirin, p. 6 below).

There is a variety of Products which are listed amongst those who either help spreading tumors or metastases, others work against inflammation, others stimulate bacteria to support the immun system or help deactivate unhelpful content of other food.
Amongst these are:

whole meal products:
Sour dough bread, whole grain noodles,
whole grain rice, basmati rice
various forms of muesli (oat, millet ...)

vegetables:
legumes (lentils, peas, beans, chick peas, soja beans)
all sorts of greens (sprouts, chinese cabbage, brokoli, cauliflower)
carrots, sweet potatoes, pumpkin, tomatoes, beetroot, spinache
mushrooms (shiitake, champignons, oyster mushroom, king oyster)

fruits
red berries (strawberries, black berries, raspberries, cherries ...)
peach, mango, apricots, pomegranate)
citrus fruits (oranges, mandarines, citron, grapefruit)

herbs
tumeric (mixed with olive oil and black pepper)
curry
peppermint, tyme, marjoram, basil, oregano, rosemary, seleriac, parsley
garlic, onions, leek
cinnamon, ginger

nuts
walnuts, hazelnuts, pecan nuts, almonds

fish and meat
salmon, small macrels, sardines, tuna (even in the tin)
meat from free range, free range eggs (from time to time)

Drinks
water with lemon juice, tyme, orange peal or zest
green tea (see note on Bortezomib therapy), especially Sencha
ginger on hot water
1 glass of red wine with a meal (from time to time)

Sweets
dark chocolate (70%)
 

Further resources on dietary recommendations:

Nicole Quirin, Ernährung bei Krebserkrankungen (s.l., 2011).

Resource links for dietary recommendations

American Heart Association	http://circ.ahajournals.org/cgi/reprint/CIRCULATIONAHA.106.176158
American Diabetes Association	http://care.diabetesjournals.org/cgi/reprint/31/Supplement_1/S61
American Dietetic Association	http://www.eatright.org/cps/rde/xchg/ada/hs.xsl/nutrition_12286_ENU_HTML.htm
Caring 4Cancer	http://www.caring4cancer.com/go/cancer/nutrition/
Centers for Disease Control and Prevention	http://www.cdc.gov/nccdphp/dnpa/nutrition/index.htm
American Institute for Cancer Research	http://www.aicr.org
National Institute of Health, National Heart Lung and Blood Institute	http://www.nhlbi.nih.gov/health/public/heart/hbp/dash/dash_brief.pdf
Office of Cancer Complementary and Alternative Medicine	http://www.cancer.gov/CAM/health_aboutcam.html

 

- Elisa V. Bandera, Lawrence H. Kushi and Lorna Rodriguez-Rodriguez published another interesting article on ‘Nutritional Factors in Ovarian Cancer Survival’ in the journal Nutrition and Cancer 61/5 (2009): 580-586. First they show that relatively little research has been done in this area and they mention the following studies:

-       Yang , L , Klint , A , Lambe , M , Bellocco , R Riman , T . 2008. Predictors of ovarian cancer survival: a population-based prospective study in Sweden. Int J Cancer, 123: 672–679.

-       Nagle , C M , Purdie , D M , Webb , P M , Green , A Harvey , P W . 2003. Dietary influences on survival after ovarian cancer. Int J Cancer, 106: 264–269.

-       Zhang , M , Lee , A H , Binns , C W and Xie , X . 2004. Green tea consumption enhances survival of Zhang , M , Lee , A H , Binns , C W and Xie , X . 2004. Green tea consumption enhances survival of Zhang , M , Lee , A H , Binns , C W and Xie , X . 2004. Green tea consumption enhances survival of epithelial ovarian cancer. Int J Cancer, 112: 465–469.
Zhang , M , Lee , A H , Binns , C W and Xie , X . 2004. Green tea consumption enhances survival of epithelial ovarian cancer. Int J Cancer, 112: 465–469.

The main focus, then of this article is on the BMI (Body Mass Index) with its evaluation of the impact of obesity on stage of disease at diagnosis, as well as its effect on survival: ‘Survival analyses need to include important covariates, such as age, stage, grade, histologic type, presence of ascites, and treatment information. Of relevance is not just weight or BMI prediagnosis or at the time of diagnosis but also during and after treatment’. Again, there are only a limited number of studies to have dealt with this issue that filtered into the above mentioned guidelines.

 

More, however has been done on physical activity and ovarian cancer survivors, although most older studies deal with physical activity and cancer prevention and much more research needs to be done on this topic. Yet, recently an important study appeared as hard copy and ebook on physical activity and cancer with a special chapter by Karen M. Gil (et al.) on ‘Physical Activity and Gynecologic Cancer Survivorship’ (pp. 305-15). The chapter concludes that, although, physical activity improves life’s quality, the impact on overall survival has not been established yet and needs further research.

Similar results can be found in the study by Vivian E. von Gruenigen, Heidi E. Frasure, Mary Beth Kavanagh, Edith Lerner, Steven E. Waggoner and Kerry S. Courneya who have published their study onivian E. von GruenigenSearch for articles by this author

·Summa Health System/Akron City Hospital, Akron, OH, USA

·Corresponding author at: Summa Akron City Hospital, 525 East Market Med II, POB # 2090, Akron, OH 44309, USA. Fax: +1 330 375 7813.

·University of Alberta, Edmonton, AB, Canada

'Feasibility of a lifestyle intervention for ovarian cancer patients receiving adjuvant chemotherapy’, Gynecologic Oncology 122/2 (2011): 328-33.

The result of their study was that with 27 patients enrolled there was a ‘moderate to strenuous physical activity’ which ‘was correlated with higher physical well-being during chemotherapy’. And they conclude that ‘Lifestyle counseling during adjuvant chemotherapy for ovarian cancer is feasible and may improve physical activity and diet quality’. To learn more, they suggest further trials.

Likewise, Stevinson, Clare PhD*; Steed, Helen MD†; Faught, Wylam MD†; Tonkin, Katia MD‡; Vallance, Jeffrey K. PhD*; Ladha, Aliya B. MSc*; Schepansky, Alexandra MD†; Capstick, Valerie MD†; Courneya, Kerry S. PhD*, looked at ‘Physical Activity in Ovarian Cancer Survivors: Associations With Fatigue, Sleep, and Psychosocial Functioning’, International Journal of Gynecological Cancer 19/1 (2009): 73-78 and found out that ‘Ovarian cancer survivors who were meeting physical activity guidelines reported more favorable outcomes of fatigue, peripheral neuropathy, sleep, and psychosocial functioning.’

Already before a similar team, Clare Stevinson et al., ‘Associations between physical activity and quality of life in ovarian cancer survivors’, Gynecologic Oncology 106/1 (2007): 244–50, to find out that ‘few ovarian cancer survivors are meeting public health physical activity guidelines, but those that are meeting guidelines report significantly and meaningfully better quality of life. Clinical trials investigating the causal effects of physical activity on quality of life in ovarian cancer survivors are warranted’.

·Katia Tonkin^c,

·Aliya B. Ladha^a,

·Jeffrey K. Vallance^a,

·Valerie Capstick^b,

·Alexandra Schepansky^b,

·Kerry S. Courneya^{a, ,}

Clare Stevinson^a,

Wylam Faught^b,

Helen Steed^b,

Katia Tonkin^c,

Aliya B. Ladha^a,

Jeffrey K. Vallance^a,

Valerie Capstick^b,

Alexandra Schepansky^b,

Kerry S. Courneya^{a, ,}