Life In Ovarian Cancer Survivors Research Articles

Utilization of an Electronic Patient-Reported Outcome Platform to Evaluate the Psychosocial and Quality-of-Life Experience Among a Community Sample of Ovarian Cancer Survivors.

Novel distress screening approaches using electronic patient-reported outcome (ePRO) measurements are critical for the provision of comprehensive quality community cancer care. Using an ePRO platform, the prevalence of psychosocial factors (distress, post-traumatic growth, resilience, and financial stress) affecting quality of life in ovarian cancer survivors (OCSs) was examined. A cross-sectional OCS sample from the National Ovarian Cancer Coalition-Illinois Chapter completed web-based clinical, sociodemographic, and psychosocial assessment using well-validated measures: Hospital Anxiety/Depression Scale-anxiety/depression, Post-traumatic Growth Inventory, Brief Resilience Scale, comprehensive score for financial toxicity, and Functional Assessment of Cancer Therapy-Ovarian (FACT-O/health-related quality of life [HRQOL]). Correlational analyses between variables were conducted. Fifty-eight percent (174 of 300) of OCS completed virtual assessment: median age 59 (range 32-83) years, 94.2% White, 60.3% married/in domestic partnership, 59.6% stage III-IV, 48.8% employed full-time/part-time, 55.2% had college/postgraduate education, 71.9% completed primary treatment, and median disease duration 6 (range < 1-34) years. On average, OCS endorsed normal levels of anxiety (mean ± standard deviation = 6.9 ± 3.8), depression (4.1 ± 3.6), mild total distress (10.9 ± 8.9), high post-traumatic growth (72.6 ± 21.5), normal resilience (3.7 ± 0.72), good FACT-O-HRQOL (112.6 ± 22.8), and mild financial stress (26 ± 10). Poor FACT-O emotional well-being was associated with greater participant distress (P < .001). Partial correlational analyses revealed negative correlations between FACT-O-HRQOL and anxiety (r = -0.65, P < .001), depression (r = -0.76, P < .001), and total distress (r = -0.92, P < .001). Yet, high FACT-O-HRQOL was positively correlated with post-traumatic coping (r = 0.27; P = .006) and resilience (r = 0.63; P < .001). ePRO assessment is feasible for identification of unique psychosocial factors, for example, financial toxicity and resilience, affecting HRQOL for OCS. Future investigation should explore large-scale, longitudinal ePRO assessment of the OCS psychosocial experience using innovative measures and community-based advocacy populations.

Symptom Clusters and Quality of Life According to the Survivorship Stage in Ovarian Cancer Survivors.

This cross-sectional study evaluated a convenience sample comprising 182 ovarian cancer survivors to identify symptom clusters according to the cancer survivorship stage and to determine their effects on quality of life using the European Organization for Research and Treatment of Cancer Quality of Life-C30 and -OV28 questionnaires. Factor and multiple regression analyses were performed to identify symptom clusters according to the cancer survivorship stage and the symptom clusters that affected the quality of life in each cancer survivorship stage, respectively. Participants in the acute, extended, and permanent survival stages accounted for 33%, 36.3%, and 30.7% of subjects, respectively. Overall, the most common symptom cluster was fatigue-diarrhea, and the symptom clusters affecting the quality of life differed according to the cancer survivorship stage. Thus, to improve the quality of life of ovarian cancer survivors, the main symptom clusters of each cancer survivorship stage must be identified, and management strategies for the related symptoms must be designed.

Health-related quality of life in ovarian cancer survivors: Results from the American Cancer Society's Study of Cancer Survivors — I

ObjectiveThere are limited data on outcomes and predictors of health-related quality of life (HRQOL) of ovarian cancer survivors. Therefore, we examined the trajectory and predictors of HRQOL one- and two-years post-diagnosis in this population. Methods365 ovarian cancer survivors, a subset of participants in the longitudinal American Cancer Society's Study of Cancer Survivors-I, completed questionnaires at one-year post-diagnosis on sociodemographics, clinical factors, and HRQOL (SF-36). 284 women had HRQOL data at two-years post-diagnosis. In this secondary data analysis, we examined HRQOL at both time points, changes in HRQOL and predictors of HRQOL with univariate and multivariate linear regression. ResultsMean mental and physical HRQOL scores one-year post-diagnosis were 49.37 (SD±11.59) and 45.96 (SD±10.89), respectively. Older age, lower income, higher disease stage, more comorbidities and greater symptom burden were associated with poorer physical functioning one year post-diagnosis. Younger age, higher stage, having an existing mental health issue, greater symptom burden, and not receiving chemotherapy were associated with poorer mental functioning. Disease recurrence between one- and two-years post-diagnosis and greater symptom burden were predictors of declining physical functioning from one- to two-years post-diagnosis. Mental functioning did not change significantly between assessments. ConclusionsOverall mental and physical functioning of these ovarian cancer survivors was similar to the general population. However, lower HRQOL was associated with a number of variables, including disease recurrence, treatment status, symptom burden, age, and number of comorbidities. These findings can help health care providers identify survivors who may benefit from relevant interventions.

Body mass index, physical activity and quality of life of ovarian cancer survivors: Time to get moving?

ObjectiveTo evaluate the association between body mass index (BMI), physical activity (PA) and the quality of life (QoL) of ovarian cancer survivors. MethodsWe performed a two-centre cross-sectional study of women who had been treated for ovarian cancer between January 2007 and December 2014 at the Royal Cornwall Hospital Trust and the Plymouth Hospitals NHS Trust. QoL was assessed using the EORTC QLQ-C30 and QLQ-OV28 questionnaires, and PA using the Godin Leisure Time Exercise questionnaire. ResultsIn total, 293 ovarian cancer survivors were invited to participate, of which 209 women (71.3%) responded. Thirty-five percent of women were overweight and 18% were obese, whilst only 21% met recommendations for PA. Obesity was associated with significantly poorer global QoL, physical, cognitive and social functioning, a poorer body image and more symptomatology. Sedentary behaviour was associated with poorer QoL scores including global QoL, physical, role, social and sexual functioning. After adjustment, BMI and PA both remained independently associated with QoL scores. ConclusionObesity and inactivity are associated with poorer QoL among ovarian cancer survivors. Future interventions promoting PA and weight loss should be evaluated as possible means to improve the QoL of this population.

Quality of life in ovarian cancer survivors: the influence of obesity.

In this study, we evaluated the effect of body mass index (BMI) on the quality of life of ovarian cancer survivors. Women diagnosed with ovarian cancer at the Royal Cornwall Hospital Trust between January 2008 and May 2013 were identified. Ovarian cancer survivors were invited to participate by completing the European Organization for Research and Treatment of Cancer QLQ-C30 (quality of life) questionnaire. Univariate and multiple regression analyses were used to determine associations between BMI and quality-of-life outcomes. A total of 176 ovarian cancer survivors were invited to participate, of which 133 were eligible for this study. In total, 81 ovarian cancer survivors (60.4%) completed the questionnaire, of which 26 responders (32.1%) were overweight (BMI, 25-29.9 kg/m²) and 27 (33.3%) were obese (BMI, ≥30 kg/m²). Increasing BMI was significantly associated with poorer quality-of-life outcomes in terms of physical functioning and emotional functioning, and this effect persisted for physical functioning after multiple regression analysis. Increasing BMI is associated with poorer quality-of-life outcomes in terms of physical and emotional functioning in ovarian cancer survivors. Further research is needed to evaluate the association between BMI and quality of life from diagnosis to survivorship to develop novel interventions.

Improving the Quality of Life in Ovarian Cancer Survivors Using the Female Sexual Function Index [359

Improving the Quality of Life in Ovarian Cancer Survivors Using the Female Sexual Function Index [359

The Effect of Comprehensive Care Program for Ovarian Cancer Survivors.

This study was done to investigate the effects of comprehensive care program on cardiopulmonary function, muscle strength, immune response, and quality of life in ovarian cancer survivors. Participants were 40 ovarian cancer survivors, 20 in the experimental group and 20 in the control group, at C university hospital gynecological cancer center from May 2009, to December 2010. The treatment was a comprehensive care program for 8 weeks consisting of group education and self-help group support, home-based exercise, and relaxation. Data were analyzed by t test and repeated-measures ANOVA. Cardiopulmonary function, measured by 12-min walk distance; muscle strength, measured by the chair-stand test; and quality of life were more increased in the experimental group. But immune response was not statistically significant. These results indicate that the comprehensive care program is an effective nursing intervention to improve cardiopulmonary function, muscle strength, and quality of life in ovarian cancer survivors.

Determinants of Quality of Life in Ovarian Cancer Survivors: A Pilot Study

ObjectiveOvarian cancer treatments and outcomes vary substantially, yielding a diverse group of survivors. Few data exist on quality of life (QoL) concerns and the foremost needs of these patients. Our goal was to conduct a pilot study to determine the QoL needs of ovarian cancer survivors to establish priorities for future interventions. MethodsIn this cross-sectional study, the European Organization for Research and Treatment of Cancer Quality of Life Questionnaires (EORTC QLQ-C30 and OV28) QoL questionnaires and one investigator-derived questionnaire were administered in an outpatient setting. Clinical parameters were abstracted and tested for associations with QoL measures. ResultsA total of 102 women consented to participate and completed all components. Their mean age was 58years (range 29 to 85), with 80% having epithelial ovarian carcinoma and 66% high-grade serous carcinoma. Women with stage I (28%), II (15%), III (47%), and IV (10%) lesions were represented in the primary treatment (25%), surveillance (46%), recurrent (23%), and palliative (7%) phases of the survivorship continuum. Fifty-one percent characterized their disease burden as “quite a bit” or ”very much,” and this did not vary by histology or diagnoses. Global QoL did not vary by clinico-pathologic parameters. Cardiovascular and respiratory comorbidities were associated with EORTC scores in physical functioning (P=0.027 for cardiovascular and P=0.041 for respiratory), global QoL (P=0.03 for cardiovascular and P=0.039 for respiratory), and sexual health (P=0.025 for cardiovascular). Task completion/memory/concentration, anxiety, and fatigue were the distress categories given highest priority by respondents. ConclusionIn women with ovarian cancer, clinical factors such as age, stage, and histology did not have a significant impact on QoL. Psychosocial factors have a larger impact on global QoL than physical symptoms.

The Effect of Regular Exercise and Yoga on Health-Related Quality of Life Among Ovarian Cancer Survivors

There is growing interest in understanding the influence of yoga on health outcomes and health-related quality of life among cancer survivors. This cross-sectional study evaluated the effects of participating in regular exercise alone or in conjunction with yoga on health-related quality of life among 219 ovarian cancer survivors using the SF-36 health survey. Multivariate regression was used to assess the association between the exercise/yoga categories on the 8 SF-36 scales. The results suggest that survivors who participated in both regular exercise and yoga had higher scores in physical functioning, fewer limitations with physical and emotional health, less pain, and more vitality than survivors who reported participating in regular exercise only. These results highlight the utility of exercise as a potential predictor of health-related quality of life in ovarian cancer survivors and support adding yoga to an exercise program.

Physical activity preferences of ovarian cancer survivors

Regular physical activity is positively associated with quality of life in ovarian cancer survivors, but no data exist on how best to promote activity in this population. This study investigated the interests and preferences of ovarian cancer survivors with regard to physical activity participation. A provincial, population-based postal survey of ovarian cancer survivors in Alberta, Canada, was performed including measures of self-reported physical activity, medical and demographic variables, and physical activity preferences. A total of 359 women participated (51.4% response rate). Over half expressed interest in participating in a physical activity program (53.8%), with a further 32.9% maybe interested. The most common preferences were for programs to be home-based (48.9%), start post-treatment (69.5%), and involve walking (62.7%). There were differences in preferences based on demographic, but not medical, factors. The majority of ovarian cancer survivors expressed interest in participating in physical activity programs; however, some preferences varied by demographic factors. Designing physical activity interventions according to these preferences may optimize adherence and outcomes in ovarian cancer survivors.

Associations between physical activity and quality of life in ovarian cancer survivors

Objectives To estimate the prevalence of physical activity in ovarian cancer survivors and to determine if there is a dose–response relationship between physical activity and quality of life. Methods Ovarian cancer survivors identified from a Canadian provincial cancer registry were mailed a questionnaire measuring self-reported leisure time physical activity (Godin Leisure Time Exercise Questionnaire), cancer-specific quality of life (Functional Assessment of Cancer Therapy–Ovarian), and standard demographic and medical variables. Results Completed questionnaires were received from 359 (51.4%) participants. Analyses indicated that 31.1% were meeting public health physical activity guidelines (i.e., at least 60 min of strenuous or 150 min of moderate/strenuous physical activity per week). Comparisons using different volumes of physical activity showed support for the current guidelines. Specifically, participants meeting current physical activity guidelines reported significantly better quality of life than those not meeting guidelines [mean difference: 12.5; 95% CI: 9.1 to 16.0; p < 0.001; d = 0.75]. Disease status was the only variable to moderate this association. Adjusting for important demographic and medical variables did not alter the findings. Conclusions 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.

Associations between Physical Activity and Quality of Life in Ovarian Cancer Survivors

Associations between Physical Activity and Quality of Life in Ovarian Cancer Survivors

Psychological well being and quality of life in ovarian cancer survivors

This report offers a unique analysis of the psychological distress associated with ovarian cancer in a review of natural correspondence between ovarian cancer survivors and an ovarian cancer newsletter. A review of 21,806 letters, cards, and e-mails reflecting correspondence from January 1994 to December 2000 between ovarian cancer survivors and the founding editor of Conversations!: The International Newsletter for those Fighting Ovarian Cancer was performed using ethnographic qualitative research methods. Statements related to the impact of disease were bracketed and coded within physical, psychological, social, and spiritual domains according to the City of Hope Quality of Life Ovarian Cancer instrument. Statements that reflected psychological well being were then evaluated with respect to the disease trajectory (i.e., diagnosis, treatment, remission, recurrence, and advanced disease/end of life). A total of 1282 communications were identified that pertained to psychological well being. Findings based on major themes derived from the analysis included descriptions of stressors associated with disease status. Significant stressors were identified within all phases of diagnosis, treatment, remission, and recurrence. Women described both positive and negative effects of disease and frequently demonstrated resourcefulness and perseverance by sharing coping mechanisms and survival strategies. The natural correspondence from women with ovarian cancer provided a rare opportunity to capture the psychological concerns of women throughout all stages of the cancer trajectory. Health care professionals' awareness of the common psychological stressors throughout the ovarian cancer trajectory may allow them to identify more readily the needs for support, leading to improvement in overall quality of life.

“What Doesn't Kill You Makes You Stronger”: An Ovarian Cancer Survivor Survey

Objectives. This survey was designed to learn more about the physical health and quality of life of ovarian cancer survivors without known active disease and not on treatment.Methods. Women with ovarian cancer without evidence of active disease, and not on treatment for at least 2 years, were recruited in Canada and the United States from university cancer clinics, community ovarian support groups, and a cancer survivor network newsletter and asked to complete an anonymous mail-back survey on their physical, psychological, social, and spiritual well-being.Results. Two-hundred (67.5%) women responded. Their mean age was 55.3 years, 72.5% had children, and they had been diagnosed with ovarian cancer a mean of 7.2 years previously. Eighty-nine percent regarded their health as good or excellent, but 53.5% had current pain or discomfort. They reported better mental health and equivalent energy levels to the general population. Although 57% reported that their sex lives had been negatively affected by cancer and its treatment, their overall sense of loss relating to sexual functioning was moderate to low. However, women under age 55 years reported a greater sense of loss about sexual function and fertility (P = 0.001). Most women reported that their ovarian cancer experience had changed their views on life and relationships in an overwhelmingly positive way.Conclusion. Most ovarian cancer survivors, despite some symptoms, enjoyed good physical, psychological, social, and spiritual health. Specific concerns emerged about sexuality which should be addressed in patient education. Having survived a life-threatening illness, ovarian cancer survivors appear to have put other life difficulties into perspective, altered their priorities, and felt enriched by the experience. In general, these women showed impressive and inspiring resilience and reported good physical health and energy, excellent psychological health, and feelings of greater pleasure in life and personal relationships.