Patient-Reported Mobility, Physical Activity, and Bicycle Use after Vulvar Carcinoma Surgery

SIMPLE SUMMARY: For patients who are treated for vulvar cancer, walking and bicycling can become uncomfortable or painful. This can result in losses in mobility, physical activity, social contacts, self-reliance, and quality of life (QoL). We assessed the prevalence and severity of these problems using three questionnaires. In total, 84 patients who were treated for vulvar cancer between 2018 and 2021 participated. The reported QoL and perceived health were 0.832 ± 0.224 and 75.6 ± 20.0, respectively. Many patients indicated that saddle use has become painful, and that they experienced moderate or severe bicycling problems or could not bicycle (40.3%). Overall, patients treated for vulvar cancer reported a lower self-reported health, mobility, and physical activity, compared to baseline values found in the literature. The weekly time spent on walking, bicycling, and participating in sports was also reduced. This motivates us to investigate ways to reduce discomfort during physical activities, and help women regain their mobility and self-reliance. ABSTRACT: Patients treated for vulvar carcinoma may experience losses in mobility and physical activity. In this study, we assess the prevalence and severity of mobility problems using patient-reported outcomes of three questionnaires: EQ-5D-5L to estimate QoL and perceived health; SQUASH to estimate habitual physical activity; and a problem-specific questionnaire on bicycling. Patients treated for vulvar carcinoma between 2018 and 2021 were recruited, and 84 (62.7%) responded. The mean age was 68 ± 12 years (mean ± standard deviation). Self-reported QoL and perceived health were 0.832 ± 0.224 and 75.6 ± 20.0, respectively. Dutch physical activity guidelines were met by 34.2% of participants. Compared to baseline values, the times spent walking, bicycling, and participating in sports were all reduced. During bicycling, patients experienced moderate or severe pain in the skin of the vulva (24.5%), pain in the sit bones (23.2%), chafing (25.5%), or itching (8.9%). Overall, 40.3% experienced moderate or severe bicycling problems or could not bicycle, 34.9% felt that their vulva impeded bicycling, and 57.1% wished to make more or longer bicycling journeys. To conclude, vulvar carcinoma and its treatment reduce self-reported health, mobility, and physical activity. This motivates us to investigate ways to reduce discomfort during physical activities, and help women regain their mobility and self-reliance.