Academic Article, December 2025

Behavioral Modification and Health Care After Gynecologic Cancer Treatment 

Gp.Capt. Piyawan Pariyawateekul, Flt.Lt Pichamon Sukkasame 
Department of Obstetrics and Gynecology, Bhumibol Adulyadej Hospital 

          The diagnosis of gynecologic cancer, e.g. ovarian cancer, cervical cancer, or endometrial cancer, is considered a major turning point in the woman’s life. Intensive cancer treatments, as surgery, chemotherapy, or radiation therapy, may be lead to the body and mental exhausted. However, after completing the treatment period, “life after cancer” still requires continuous cares. Behavioral modification after completing treatment is considered one of the key factors that will help patients return to a good quality life and reduce the chance of recurrence.¹  

          Many medical research studies indicate that self-care after cancer treatment improves survival rates and long-term quality of life.² Appropriate behaviors help reduce the risk of disease recurrence, prevent the occurrence of other chronic diseases such as diabetes, hypertension, or heart disease, and also help the body recover faster, reduce fatigue, and increase the will to live.³ 

Principles of Behavioral Modification and Health Care 

1. Nutrition for Health

      Good nutrition for patients after cancer treatment should focus on body recovery and reducing inflammation. “Good food is the best medicine.” Patients should eat a plant-based diet, that emphasizes fresh vegetables and fruits, which are rich in antioxidants, and protein from fish, legumes, and whole grains. Meanwhile, fried foods, foods high in saturated fat or sugar, and processed foods should be avoided.
      The Women’s Healthy Eating and Living (WHEL Study) research found that consuming more than 5 servings of vegetables and fruits per day, combined with reducing fat to less than 20% of total energy, it was associated with improved quality of life and favorable survival trends in certain subgroups.4 Moreover, drinking 6–8 glasses of clean water per day will help the excretory system function well and reduce the risk of constipation, which is a common problem in patients after completing treatment. 

2. Appropriate Exercise

       Exercise after completing treatment is not only helps improve physical fitness but also significantly reduces cancer-related fatigue and depression.5 The guidelines from the American College of Sports Medicine (ACSM) 2019 have the following recommendations:5 

• Should exercise at a moderate level for at least 150 minutes per week. Those who follow this have a survival rate approximately 33% higher than those who do not exercise.³

• Cancer survivors who exercise regularly have approximately 20–30% higher survival rates compared with physically inactive individuals5 
  

• Women who just finished treatment, such as surgery or chemotherapy, should start by walking slowly and then gradually increase intensity. 
  

• Should avoid exercises that put pressure on the surgical wound area or abdomen. 

        Patients may start with brisk walking for 20–30 minutes per day, yoga, or gentle stretching. If there are health limitations, they should consult a doctor or physical therapist to develop an appropriate exercise program. Furthermore, patients with endometrial cancer and ovarian cancer should maintain weight within appropriate ranges which increased survival rates by 15–30% compared to inactive groups.5 

3. Mental Health Care

        Facing cancer can cause anxiety, fear of recurrence, or depression. Stress and anxiety can be managed through various methods such as meditation practice, deep breathing, and enjoyable activities of interest which like reading, listening to music, or creating artwork – all of which help relax the mind. 
        Mental health care and support networks, such as support groups or mindfulness activities, can significantly reduce cortisol hormone levels and increase immunity. This results in improved quality of life and a higher tendency for long-term survival.6 However, patients with chronic or severe depression symptoms should consult a mental health specialist. 

4. Follow-up Treatment

         After completing treatment, patients should regularly attend follow-up appointments according to the doctor’s recommendations to assess abnormal symptoms, check for recurrence, and monitor side effects from treatment.7 Patients should watch for abnormal symptoms by themselves such as abnormal bleeding, unexplained weight loss, lower abdominal pain, or bloating. if any abnormalities occur, patiens should see a doctor promptly. The continuous follow-up simultaneous with good behavioral modification is therefore the foundation of a true “new life after cancer”. 

Conclusion
          Facing gynecologic cancer may be a hard test of life, but it is also an opportunity for women to learn to take better care of themselves. Behavioral modification in nutrition, exercise, mental health care, and regular follow-up treatment will help patients change their status from “patient” to “survivor” gracefully and continuing to live with a strong heart full of hope. 

References 

1. National Comprehensive Cancer Network (NCCN). NCCN Guidelines for Patients: Ovarian, Cervical, and Uterine Cancers. Plymouth Meeting (PA): NCCN; 2023. 
   

2. World Health Organization (WHO). Guide to cancer early diagnosis. Geneva: World Health Organization; 2017. 

3. Rock CL, Thomson C, Gansler T, Gapstur SM, McCullough ML, Patel AV, Jacobs EJ, et al. American Cancer Society guideline for diet and physical activity for cancer prevention. CA Cancer J Clin. 2020;70(4):245-71. 

4. Pierce JP, Natarajan L, Caan BJ, Parker BA, Greenberg ER, Flatt SW, et al. Influence of a diet very high in vegetables, fruit, and fiber and low in fat on prognosis following treatment for breast cancer: the Women’s Healthy Eating and Living (WHEL) randomized trial. JAMA. 2007;298(3):289–98. 

5. Patel AV, Friedenreich CM, Moore SC, Hayes SC, Silver JK, Campbell KL, et al. American College of Sports Medicine Roundtable report on physical activity, sedentary behavior, and cancer prevention and control. Med Sci Sports Exerc. 2019;51(11):2391–402. 

6. Antoni MH, Lechner SC, Kazi A, Wimberly SR, Sifre T, Urcuyo KR, et al. How stress management improves quality of life after treatment for breast cancer: a randomized trial. J Consult Clin Psychol. 2006;74(6):1143–52. 

7. Miller KD, Nogueira L, Mariotto AB, Rowland JH, Yabroff KR, Alfano CM, et al. Cancer treatment and survivorship statistics, 2019. CA Cancer J Clin. 2019;69(5):363–85.