Monitoring physical and psychosocial symptom trajectories in ovarian cancer patients receiving chemotherapy

Abstract

BackgroundDiagnosis and treatment of ovarian cancer (OC) entail severe symptom burden and a significant loss of quality of life (QOL). Somatic and psychological impairments may persist well beyond active therapy. Although essential for optimal symptom management as well as for the interpretation of treatment outcomes, knowledge on the course of QOL-related issues is scarce. This study aimed at assessing the course of depressive symptoms, anxiety, fatigue and QOL in patients with OC over the course of chemotherapy until early after-care.Methods23 patients were assessed longitudinally (eight time points) with regard to symptom burden (depression, anxiety, fatigue, and QOL) by means of patient-reported outcome instruments (HADS, MFI-20, EORTC QLQ-C30/-OV28) and clinician ratings (HAMA/D) at each chemotherapy cycle and at the first two aftercare visits.ResultsStatistically significant decrease over time was found for depressive symptoms and anxiety as well as for all fatigue scales. With regard to QOL, results indicated significant increase for 11 of 15 QOL scales, best for Social (effect size = 1.95; p < 0.001), Emotional (e.s. = 1.62; p < 0.001) and Physical Functioning (e.s. = 1.47; p < 0.001). Abdominal Symptoms (e.s. = 1.01; p = 0.009) decreased, Attitudes towards Disease and Treatment (e.s. = 1.80; p < 0.001) improved significantly over time. Analysis of Sexual Functioning was not possible due to a high percentage of missing responses (61.9%).ConclusionsThe present study underlines the importance of longitudinal assessment of QOL in order to facilitate the identification of symptom burden in OC patients. We found that patients show high levels of fatigue, anxiety and depressive symptoms and severely impaired QOL post-surgery (i.e. at start of chemotherapy) but condition improves considerably throughout chemotherapy reaching nearly general population symptoms levels until aftercare.

Sexual Health and Quality of Life Assessment among Ovarian Cancer Patients during Chemotherapy

“…Nevertheless, this study also confirmed that the QoL improves with ongoing treatment and continues to get better after the end of CT, reaching a level similar to that of the general female population [17,18]. The authors underlined the importance of longitudinal assessment of QoL in order to facilitate the identification of symptom burden in EOC patients.…”

“…Unfortunately, very few authors have studied this topic before, but as previously shown by Meraner et al [17], there is a significant deterioration in QoL during CT, especially at the beginning of the treatment and immediately after the first cytoreductive surgery. Nevertheless, this study also confirmed that the QoL improves with ongoing treatment and continues to get better after the end of CT, reaching a level similar to that of the general female population [17,18].…”

“…The authors underlined the importance of longitudinal assessment of QoL in order to facilitate the identification of symptom burden in EOC patients. Patients showed high levels of fatigue, anxiety and depressive symptoms and severely impaired QoL after surgery, but their condition improved considerably throughout CT, reaching nearly general population symptom levels until aftercare [17]. …”

Elevation of vascular endothelial growth factor and distress in ovarian cancer patients: are they correlated? The pilot trial

“…В данной работе определено, что бо льшая часть пациенток, страдающих онкологическими заболева-ниями, испытывают дистресс, тревогу и депрессию субклинического уровня, что было показано и в ранее проведенных исследованиях [12]. Так, известно, что сам факт постановки диагноза онкологического заболевания является сильным психотравмирующим фактором [13].…”

Symptom Experience and Self-rated Physical Functioning in Patients With Ovarian Cancer Receiving Chemotherapy

“…6,7 Most symptom prevalence studies are cross-sectional offering only a snapshot of the cancer experience often conducted among heterogeneous groups of patients with gynecological cancer. 2,3,8Y10 Longitudinal studies on symptoms during and after treatment for ovarian cancer have examined symptom persistence and associated symptom burden over time, but the focus has mainly been on a narrow set of symptoms, 11,12 and as we know that symptoms affect each other negatively, this limits the understanding of symptom burden. 13 Therefore, the purpose of this study was to investigate occurrence of multiple symptoms in patients with ovarian cancer before, during, and 6 months after start of chemotherapy.…”