What do gynecologic cancer survivors desire in a survivorship program?

Abstract

Objectives: This study aims to assess the concerns and quality of life (QOL) of women treated for gynecologic cancers who were invited to participate in a survivorship program. The primary objective is to identify components of a survivorship program that would be most useful for survivors of gynecologic malignancies. Methods: This is a quality improvement initiative. Women diagnosed and treated for a gynecologic malignancy at our cancer center in 2018 were asked to participate in a survivorship survey by mail between 1/2019 and 3/2019. Additionally, women attending an inperson survivorship visit between 12/2019 and 10/2020 were asked to participate at their first visit. All data was self-reported including cross-sectional data on demographics, treatment and current symptoms. Patients’ concerns and desires for assistance were assessed using a 5-point Likert scale with 0=not helpful/no concern to 4=extremely helpful/very concerning. QOL was assessed with the Functional Assessment of Cancer Therapy (FACT-G). Descriptive statistics were performed. Results: A total of 92 women completed the survey, representing a 57% response rate. A total of 41 (45.5%) patients had uterine cancer, 40 (44.4%) had ovarian/fallopian tube/primary peritoneal cancer, and 10 (11.1%) had a lower genital tract cancer (cervical, vulvar, vaginal). A total of 83 (95.4%) of patients received initial surgery and 61 (67.8%) received adjuvant chemotherapy and/or radiation therapy with a mean time from treatment completion to survey administration of 6.0 + 7.6 months. The mean age was 61 years old + 11 years. Women with lower genital tract cancers were significantly younger than the women with uterine and ovarian cancer, respectively (50y + 10y vs. 64y + 10y vs. 61y + 12y, p 60 years old. The top 5 most-desired survivorship components included: instruction in nutrition (35%), assistance with weight loss (30%), stress reduction (27%), fatigue reduction (27%), and improved long-term side effects (24%). A total of 15% of respondents desired components focused on anxiety treatment, and less than 10% desired help with sleep, relationships, sex life, and finances. Uterine cancer survivors were more likely to desire weight loss assistance versus non-uterine survivors (37% vs 24%, p=0.05). Patients with lower genital tract cancers desired assistance with relationships more frequently when compared to uterine and ovarian groups, respectively (11% vs 5% vs 3%, p Download : Download high-res image (130KB) Download : Download full-size image Conclusions: Survivors of gynecologic cancer desire nutrition, weight loss, and stress reduction as part of their survivorship programs. Further research should be done to assess patient preferences for survivorship program content and consider age and disease type preferences to optimize personalized participation.