Susan K Lutgendorf1, Eileen Shinn2, Jeanne Carter3, Susan Leighton4, Keith Baggerly5, Michele Guindani6, Bryan Fellman6, Marianne Matzo7, George M Slavich8, Marc T Goodman9, William Tew10, Jenny Lester11, Kathleen M Moore12, Beth Y Karlan11, Douglas A Levine13, Anil K Sood14. 1. Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA, USA; Department of Obstetrics and Gynecology, University of Iowa, Iowa City, IA, USA; Department of Urology, University of Iowa, Iowa City, IA, USA; Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA, USA. Electronic address: Susan-lutgendorf@uiowa.edu. 2. Department of Behavioral Science, Division of OVP, Cancer Prevention and Population Sciences, The University of Texas, M.D. Anderson Cancer Center, Houston, TX, USA. 3. Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Gynecology Service, Department of Psychiatry and Surgery Memorial Sloan Kettering Cancer Center, New York, NY, USA. 4. Ovarian Cancer Research Fund Alliance, Washington, DC, United States. 5. Department of Bioinformatics and Computational Biology, Division of Quantitative Sciences, University of Texas, M.D. Anderson Cancer Center, Houston, TX, USA. 6. Department of Biostatistics, Division of Quantitative Sciences, University of Texas, M.D. Anderson Cancer Center, Houston, TX, USA. 7. College of Family Medicine, Stephenson Oklahoma Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA. 8. Cousins Center for Psychoneuroimmunology, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA. 9. Cancer Prevention and Genetics Program, Samuel Oschin Comprehensive Cancer Institute, Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, CA, USA. 10. Gynecologic Medical Oncology Service, Memorial Sloan Kettering Cancer Center, Weill Cornell Medicine, New York, NY, USA. 11. Women's Cancer Program, Samuel Oschin Comprehensive Cancer Institute, Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, CA, USA. 12. Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Stephenson Oklahoma Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA. 13. Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA. 14. Department of Gynecologic Oncology, University of Texas, M.D. Anderson Cancer Center, Houston, TX, USA; Department of Cancer Biology, University of Texas, M.D. Anderson Cancer Center, Houston, TX, USA; Center for RNA Interference and Noncoding RNA, University of Texas, M.D. Anderson Cancer Center, Houston, TX, USA.
Abstract
PURPOSE: Long-term survival of women with advanced-stage ovarian cancer is relatively rare. Little is known about quality of life (QOL) and survivorship concerns of these women. Here, we describe QOL of women with advanced-stage ovarian cancer surviving for 8.5 years or longer and compare women with 0-1 recurrence to those with multiple recurrences. METHODS: Participants (n=56) recruited from 5 academic medical centers and the Ovarian Cancer Research Fund Alliance completed surveys regarding QOL (FACT-O), mood (CESD), social support (SPS), physical activity (IPAQ-SF), diet, and clinical characteristics. Median survival was 14.0 years (range 8.8-33.3). RESULTS: QOL and psychological adjustment of long-term survivors was relatively good, with mean FACT-G scores (multiple recurrences: 80.81±13.95; 0-1 recurrence: 89.05 ±10.80) above norms for healthy community samples (80.1±18.1). Survivors with multiple recurrences reported more compromised QOL in domains of physical and emotional well-being (p <.05), and endorsed a variety of physical and emotional concerns compared to survivors with 0-1 recurrence. Difficulties in sexual functioning were common in both groups. Almost half (43%) of the survivors reported low levels of physical activity. CONCLUSIONS: Overall, women with advanced-stage ovarian cancer who have survived at least 8.5 years report good QOL and psychological adjustment. QOL of survivors with multiple recurrences is somewhat impaired compared to those with 0-1 recurrence. Limitations include a possible bias towards participation by healthier survivors, thus under-representing the level of compromise in long-term survivors. Health care practitioners should be alert to psychosocial issues faced by these long-term survivors to provide interventions that enhance QOL.
PURPOSE: Long-term survival of women with advanced-stage ovarian cancer is relatively rare. Little is known about quality of life (QOL) and survivorship concerns of these women. Here, we describe QOL of women with advanced-stage ovarian cancer surviving for 8.5 years or longer and compare women with 0-1 recurrence to those with multiple recurrences. METHODS:Participants (n=56) recruited from 5 academic medical centers and the Ovarian Cancer Research Fund Alliance completed surveys regarding QOL (FACT-O), mood (CESD), social support (SPS), physical activity (IPAQ-SF), diet, and clinical characteristics. Median survival was 14.0 years (range 8.8-33.3). RESULTS: QOL and psychological adjustment of long-term survivors was relatively good, with mean FACT-G scores (multiple recurrences: 80.81±13.95; 0-1 recurrence: 89.05 ±10.80) above norms for healthy community samples (80.1±18.1). Survivors with multiple recurrences reported more compromised QOL in domains of physical and emotional well-being (p <.05), and endorsed a variety of physical and emotional concerns compared to survivors with 0-1 recurrence. Difficulties in sexual functioning were common in both groups. Almost half (43%) of the survivors reported low levels of physical activity. CONCLUSIONS: Overall, women with advanced-stage ovarian cancer who have survived at least 8.5 years report good QOL and psychological adjustment. QOL of survivors with multiple recurrences is somewhat impaired compared to those with 0-1 recurrence. Limitations include a possible bias towards participation by healthier survivors, thus under-representing the level of compromise in long-term survivors. Health care practitioners should be alert to psychosocial issues faced by these long-term survivors to provide interventions that enhance QOL.
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