scholarly journals Sudden Loss of Ovarian Function Exacerbate Cancer-related Fatigue in Patients with Ovarian Carcinoma

2021 ◽  
Author(s):  
Honghong Cai ◽  
Youguo Chen ◽  
Fangrong Shen ◽  
Huating Sun ◽  
Juan Wang ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Ovarian Carcinoma ◽  
Ovarian Function ◽  
Chemotherapy Regimen ◽  
Sudden Loss ◽  
Fatigue Score ◽  
Cancer Related Fatigue ◽  
Pathological Subtype ◽  
Over Time

Abstract Objective: We aimed to investigate whether ovarian cancer and cancer-related fatigue are associated with a sudden loss of ovarian dysfunction.Methods: In total, we retrospectively analyzed 211 survivors of ovarian carcinoma from the First Affiliated Hospital of Soochow University between January 2015 and January 2020. Fatigue was measured with the Cancer Fatigue Scale (CFS). Single and multiple linear regression were used to determine statistical differences.Results: Fatigue was reported in 206 of all completed questionnaires. Patients who had a menstrual period prior to treatment had a higher fatigue score. The CRF score was highest during the first two years after treatment and gradually decreased over time. Patients with sleep disorders became fatigued more easily. We identified a negative correlation between hemoglobin and CRF. There were no significant correlations between CRF, the number of chemotherapy cycles, the type of chemotherapy regimen, or the pathological subtype of ovarian cancer.Conclusion: CRF is common in ovarian cancer patients and improve CRF are important for improving the quality of life. The fatigue experienced by patients with ovarian cancer may be related to the deprivation of sex hormones. It may be prudent to add such hormones to the treatment regimen in order to improve CRF.

Role of laparoscopy to evaluate candidates for complete cytoreduction in advanced stages of epithelial ovarian cancer

2006 ◽  
Vol 16 (Suppl 1) ◽  
pp. 35-40 ◽  
Author(s):  
X. Deffieux ◽  
D. Castaigne ◽  
C. Pomel
Keyword(s):  
Ovarian Cancer ◽  
Ovarian Carcinoma ◽  
Preoperative Evaluation ◽  
Residual Tumor ◽  
Complete Cytoreduction ◽  
Advanced Stages ◽  
Laparoscopic Evaluation ◽  
Cancer Laparoscopy

The objective of this study was to evaluate the role of laparoscopy in selecting candidates for complete cytoreduction surgery in epithelial ovarian carcinoma. We performed an explorative laparoscopy in 15 women presenting with advanced ovarian carcinoma, and for whom the preoperative evaluation was considered unsatisfactory, to define the possibility of achieving a complete cytoreduction. We focused on three sites of carcinomatosis: bowel, liver pedicle, and right diaphragmatic dome. Laparoscopic evaluation was successful in all 15 patients. Four patients were considered to have unresectable carcinomatosis because of extensive involvement of the small bowel and therefore had no laparotomy. These women underwent neoadjuvant chemotherapy in the following 2 weeks. Eleven patients were considered to have resectable peritoneal carcinomatosis (PC). Ten women had no macroscopic residual tumor after surgery. A modified posterior exenteration was performed in five patients. The laparoscopic exploration had underestimated the liver pedicle involvement in two patients, but only one had an infracentimetric residual tumor after surgery. Laparoscopy is a reliable method of exploring PC in advanced-stage ovarian cancer. Laparoscopy may obviate the need for unnecessary laparotomy in many cases and may, therefore, contribute to a better quality of life for patients found to have unresectable disease.

Shared decision-making in ovarian cancer.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 5549-5549 ◽  
Author(s):  
Lari B. Wenzel ◽  
Dana B Mukamel ◽  
Kathryn Osann ◽  
Lisa Sparks ◽  
Laura Jean Havrilesky ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Decision Making ◽  
Shared Decision Making ◽  
Decision Aid ◽  
Treatment Initiation ◽  
Treatment Decision ◽  
Shared Decision ◽  
Decisional Regret ◽  
Over Time

5549 Background: The value of shared decision-making in ovarian cancer is relatively unexplored. The goal of this study was to test a new decision aid, Patient Centered Outcome Aid (PCOA), that facilitates shared decision-making and helps ovarian cancer patients assimilate information and identify quality of life (QOL), toxicity and survival trade-offs between IP/IV therapy and IV therapy alone, based on their preferences and personal clinical characteristics. Methods: Participants were randomized to either PCOA (N=64) or usual care (N=59). Patient characteristics, QOL and shared decision-making data were collected at baseline and treatment initiation. Primary outcomes included satisfaction with treatment decision and decisional regret. Comparisons were made using t-tests and multivariate methods, adjusting for patient covariates. Multivariate linear models were used to investigate predictors of the primary outcomes. Results: Although satisfaction and decisional regret did not differ significantly by arm at any time point, the majority of PCOA patients indicated that the aid helped them understand treatment options and side effects. Notably, low shared decision-making and low QOL, were significant predictors of low satisfaction at treatment initiation (multiple r=0.76), six months (multiple r=0.48) and nine months (r=0.58). They were also significant predictors of decisional regret (multiple r=0.48 and 0.36 at 6 and 9 months). Patient covariates including age, stage, treatment and neoadjuvant status were not associated with differences in satisfaction or decisional regret. Conclusions: There were no clinically meaningful differences in satisfaction with the treatment decision, or decisional regret between the study arms. The absence of a difference may reflect the high degree of shared decision-making in both arms and greater disease severity in PCOA patients, who were more likely to report low baseline QOL and declining QOL over time. Both shared decision-making and quality of life were robust, independent predictors of satisfaction with the treatment decision over time. This implies that women who perceive themselves as less engaged in the decision process, and report poor QOL may benefit from a decision aid, in addition to physician counseling. Clinical trial information: NCT02259699.

When will I feel normal again? Quality of life trajectories after first-line chemotherapy for ovarian cancer.

2018 ◽  
Vol 36 (7_suppl) ◽  
pp. 172-172
Author(s):  
Penelope M Webb ◽  
Vanessa Beesley ◽  
Christina Nagle ◽  
Peter T. Grant ◽  
Anna deFazio ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Ovarian Cancer ◽  
General Population ◽  
Primary Treatment ◽  
Cancer Prognosis ◽  
Life Trajectories ◽  
Platinum Based Chemotherapy ◽  
Ovarian Cancer Prognosis ◽  
Over Time

172 Background: Patients often ask if/when they will feel normal again following treatment for ovarian cancer (OC). There is a paucity of data on the trajectories of quality of life (QoL), physical (PWB), social (SWB), emotional (EWB) and functional (FWB) wellbeing over time following chemotherapy and especially regarding those who have persistent problems. Our aim was to quantify the proportion of women with significantly lower QoL/wellbeing than the general population at the end of treatment and determine if/when they return to normal. Methods: The OPAL (Ovarian cancer Prognosis & Lifestyle) Study is a prospective study of Australian women diagnosed with invasive OC from 2012-15 who agreed to complete regular questionnaires after diagnosis. 580 participants who received ≥3 cycles of platinum-based chemotherapy as primary treatment and completed a questionnaire while on or < 6 weeks after completing chemotherapy (baseline) were included. FACT-G data came from questionnaires at baseline and ~3, 6, 9 & 18 months post-baseline. Group-based trajectory models were used to identify groups with distinct patterns of QoL/wellbeing over time. Results: Overall, 44% (254) of women had QoL scores significantly lower than the general population at baseline; 35% (88) returned to normal by 3 months after treatment, 73% by 6 months and 27% (69) had not returned to normal by 18 months. The Table shows the comparable figures for the wellbeing subscales. Conclusions: While > 50% of women with OC can expect similar QoL, FWB and EWB to the general population at the end of chemotherapy, PWB was compromised in 3 of 4 women. For most, wellbeing recovered within 6 months but a substantial proportion reported ongoing deficits. A particularly prolonged impact was seen for those with poor EWB at baseline, warranting early intervention in this subset. [Table: see text]

Novel Approaches in Advancing the Treatment of Epithelial Ovarian Cancer: The Role of Angiogenesis Inhibition

2007 ◽  
Vol 25 (20) ◽  
pp. 2894-2901 ◽  
Author(s):  
Lainie Martin ◽  
Russell Schilder
Keyword(s):  
Ovarian Cancer ◽  
Ovarian Carcinoma ◽  
Ovarian Function ◽  
Current Knowledge ◽  
Cancer Therapeutics ◽  
Current Data ◽  
Aggressive Approach ◽  
New Era ◽  
Angiogenesis Inhibition

Despite an aggressive approach of surgical cytoreduction and adjuvant combination chemotherapy, ovarian cancer mortality remains a significant problem. We are entering a new era of cancer therapeutics in which targeted therapies offer the potential for improvement in long-term disease control with fewer toxicities. The greatest success of targeted therapy to date in the setting of epithelial ovarian carcinoma has come from angiogenesis inhibition. This review will focus on the role of angiogenesis in normal ovarian function as well as in ovarian carcinoma development and disease progression. Current knowledge about the molecular pathways involved in angiogenesis and various approaches to angiogenesis inhibition in the treatment of ovarian cancer are discussed. Current data regarding the role of bevacizumab and other novel agents in the treatment of ovarian carcinoma are summarized.

scholarly journals Histologic Subtypes of Ovarian Carcinoma: Selected Diagnostic and Classification Problems in Bulgaria: Is Low Hospital Volume an Issue?

2016 ◽  
Vol 103 (2) ◽  
pp. 148-154 ◽  
Author(s):  
Vesela Ivanova ◽  
Tihomir Dikov ◽  
Nadya Dimitrova
Keyword(s):  
Ovarian Cancer ◽  
Quality Of Care ◽  
Ovarian Carcinoma ◽  
Cancer Patients ◽  
Hospital Volume ◽  
Clear Cell ◽  
High Volume ◽  
Ovarian Carcinomas ◽  
Low Volume

Purpose To provide an overview of the morphologic subtypes of ovarian carcinomas in Bulgaria in relation to current healthcare organization using Bulgarian National Cancer Registry data. Further, we investigated hospital volume as a factor influencing the quality of care for patients with ovarian cancer. Methods Bulgarian National Cancer Registry ovarian carcinoma data were retrieved (2009-2011) and distribution of histologic types was analyzed. Cases were divided and compared with respect to main treatment: no surgery, surgery at hospitals dealing with ≥30 ovarian cancer patients/year (high volume), and surgery at hospitals dealing with <30 ovarian cancer patients/year (low volume). We then estimated the odds of being diagnosed with adenocarcinoma and carcinoma not otherwise specified (NOS) vs specified morphologies (serous, endometrioid, clear cell, and mucinous), including age, grade, stage, and hospital volume, in a logistic regression model. Results A total of 2,041 ovarian carcinomas were distributed as follows: serous 47.7%, mucinous 11.9%, endometrioid 5.8%, clear cell 1.8%, and adenocarcinoma and carcinoma NOS 32.5%. More than half of cancer patients (n = 1,100, 53.9%) were surgically treated in low-volume hospitals and they had a larger proportion of cases with adenocarcinoma and carcinoma NOS: 33.3%, in comparison with 24.0% in high-volume hospitals (p<0.0001). The odds of being diagnosed with unspecified morphology, assumed as a proxy of suboptimal quality of care, are higher for patients surgically treated in low-volume hospitals (odds ratio 1.50 [95% confidence interval 1.21-1.87]) compared with high-volume hospitals after adjustment for age, stage, and grade. Conclusions The results of our study may serve policymakers and healthcare professionals when optimizing diagnosis and treatment of ovarian cancer in Bulgaria.

Effect of genetic testing results on patient-reported quality of life among patients undergoing panel testing for newly diagnosed ovarian cancer.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 1584-1584
Author(s):  
Sarah S. Lee ◽  
Melissa Kristen Frey ◽  
Deanna Gerber ◽  
Zachary Phillip Schwartz ◽  
Jessica Martineau ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Ovarian Cancer ◽  
Genetic Testing ◽  
Anxiety And Depression ◽  
Newly Diagnosed ◽  
Pathogenic Mutations ◽  
Patient Reported ◽  
Clinically Significant ◽  
Over Time

1584 Background: This study compared patient-reported stress, anxiety, and depression between newly diagnosed ovarian cancer patients with pathogenic genetic testing results versus patients with non-informative results (i.e., variants of uncertain significance (VUS) or negative). Methods: Patients underwent genetic testing (GT) via a facilitated referral pathway (Frey et al, Gynecol Oncol 2020) through which they were referred for genetic counseling and GT by their gynecologic oncologist within six weeks of diagnosis from 10/2015 to 5/2019. English-speaking patients completed three quality of life (QoL) instruments: Impact of Events Scale (IOES), State-Trait Anxiety Questionnaire (STAI), Hospital Anxiety and Depression Scale (HADS) immediately pre-and post-GT and 6 months post GT. Two-way mixed ANOVA was performed to analyze effect of GT results on QoL over time with significance p < 0.05. Results: One hundred ten patients were enrolled in the pathway and 83 (76%) patients underwent GT. Among these, 15 (18%) had potentially actionable pathogenic mutations ( BRCA1-8, BRCA2-4, MSH2-2, MRE11A-1); 26 (31%) had VUS results; 3 (4%) had both a pathogenic mutation and a VUS result; and 42 (51%) had negative results. Sixty patients (72%) completed QoL assessments pre and post GT, and 37 (44%) patients at 6-9 months post GT. For all patients, GT results did not affect QoL scales across our time points. By mean scores across all-comers, patients demonstrated mild stress at each time point and clinically significant anxiety immediate post-GT. All patients had a statistically significance decrease in HADS depression scores over time from pre-GT to 6 months post-GT (mean score 4.98 vs 2.97, p = 0.020). Patients with VUS had lower HADS mean anxiety scores across time (3.62) compared to patients with pathogenic (7.44) or negative mutations (6.83, p = 0.029). For patients without mutations, there was a significant decrease in clinically significant anxiety by STAI-state score at 6 months (p = 0.002) and a decrease in borderline anxiety by HADS scores at 6 months (p = 0.005). This effect was not present for patients with pathogenic mutations or VUS. Conclusions: A pathogenic result does not impact QoL scales immediately pre or post GT or at 6 months post GT, though patients with negative mutations were more likely to show a decrease in anxiety over time. Patients should be recommended GT at time of diagnosis of ovarian cancer without concern of increased stress, anxiety, or depression based on GT results.

Financial toxicity and patient-reported outcomes over time: A longitudinal study of women with recurrent ovarian cancer.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 6079-6079
Author(s):  
Larissa Meyer ◽  
Amy Schneider ◽  
Tsun Hsuan Chen ◽  
Xin Shelley Wang ◽  
Charlotte C. Sun
Keyword(s):  
Quality Of Life ◽  
Ovarian Cancer ◽  
Longitudinal Study ◽  
Multivariable Analysis ◽  
Financial Toxicity ◽  
Patient Reported ◽  
Baseline Cost ◽  
Over Time ◽  
Screening Measures

6079 Background: The chronic nature of treatment for ovarian cancer (OC) can place women at increased risk of financial toxicity (FT) from ongoing direct and indirect costs coupled with potential loss of income. We explored FT and its association with anxiety, depression, and quality of life over time in women with recurrent OC. Methods: Women with recurrent OC enrolled in a longitudinal study were given the following validated instruments at baseline and every 3 months: FACIT Comprehensive Score for Financial Toxicity (COST), GAD-7 (anxiety), CES-D (depression) and FACT-Ovary. Mixed models were performed on longitudinal data over 12 months of follow-up. Multivariable analysis of demographic data was performed. Results: 225 patients were divided into low FT (top 2 terciles, n = 152) and high FT (bottom tercile, n = 73,) by baseline COST scores. The median age was 59 (range 22.9-78.9). There were no significant differences between the groups in regards to marital status, number of people in household or education level. There were significant differences between the low and high financial toxicity groups in terms of median age (low FT = 61 yrs vs. high FT = 54 yrs, p < 0.0001); race (5.4% black in low FT vs. 15.1% in high FT, p = 0.04), number of children < 18 years in the home ((p = 0.02), employment status p( < 0.0001) and annual income p( < 0.0001). On multivariable analysis, only income and age remained significantly associated with FT. The mean baseline COST score in the low FT group was 34 vs. 16 in the high FT group. Interestingly, pts with low baseline FT had significant worsening of FT over the 12 month time period while those with high FT had slight improvement over time. Consistently, the high FT group had higher scores on screening measures for anxiety and depression, as well as lower overall quality of life which persisted over time. Conclusions: Financial toxicity is a measurable and clinically relevant patient reported outcome. The cohort of women with high FT demonstrated higher mean scores on screening measures for depression and anxiety as well as persistently lower quality of life. Targeted interventions to decrease financial toxicity may provide more global improvements in mental health and quality of life.

scholarly journals Ovarian cancer study dropouts had worse health-related quality of life and psychosocial symptoms at baseline and over time

2016 ◽  
Vol 13 (5) ◽  
pp. e381-e388 ◽  
Author(s):  
Rebecca L Mercieca-Bebber ◽  
Melanie A Price ◽  
Melanie L Bell ◽  
Madeleine T King ◽  
Penelope M Webb ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Ovarian Cancer ◽  
Health Related Quality ◽  
Cancer Study ◽  
Related Quality ◽  
Health Related ◽  
Over Time

Comparison of CA-125 and Standard Definitions of Progression of Ovarian Cancer in the Intergroup Trial of Cisplatin and Paclitaxel Versus Cisplatin and Cyclophosphamide

2006 ◽  
Vol 24 (1) ◽  
pp. 45-51 ◽  
Author(s):  
Gordon J.S. Rustin ◽  
Petra Timmers ◽  
Ann Nelstrop ◽  
Gavin Shreeves ◽  
Soeren M. Bentzen ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Ovarian Carcinoma ◽  
Randomized Trial ◽  
Therapeutic Benefit ◽  
Epithelial Ovarian Carcinoma ◽  
Ca 125 ◽  
Upper Limit ◽  
Significant Difference ◽  
Intergroup Trial ◽  
Over Time

Purpose A definition for progression of ovarian cancer has been proposed based on either a confirmed doubling of CA-125 levels from the upper limit of normal or from the nadir level if levels are persistently elevated. Retrospectively, we determined whether the use of this CA-125 definition in a randomized trial would have shown the same magnitude of difference between the treatment arms as was shown when the standard progression definition was used. Patients and Methods A retrospective analysis was performed on 680 patients in the Taxol Intergroup Trial with advanced epithelial ovarian carcinoma, of whom 628 were assessable according to CA-125. The date of progression according to clinical or radiologic criteria was compared with the date of progression according to CA-125. Results Of the 628 patients assessable for both definitions, 556 clinical or radiologic progressions were determined compared with 389 according to the CA-125 definition. There was a highly significant difference in the hazard of progression between the paclitaxel and cisplatin arm (TP) compared with the cyclophosphamide and cisplatin arm (CP) when either standard or CA-125 criteria were used to define progression (standard, P = .002; CA-125, P = .011). The hazard ratio of TP/CP over time was similar when comparing the different methods of defining progression. Conclusion The results of this analysis show that the magnitude of the therapeutic benefit was similar whether CA-125 or standard criteria were used to define progression.

Psychological and Cognitive Aspects of Borderline Intellectual Functioning

2017 ◽  
Vol 22 (3) ◽  
pp. 159-166 ◽  
Author(s):  
Bastianina Contena ◽  
Stefano Taddei
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Intellectual Functioning ◽  
Clinical Impact ◽  
Review Of The Literature ◽  
Borderline Intellectual Functioning ◽  
General Quality ◽  
Meta Analyses ◽  
Over Time

Abstract. Borderline Intellectual Functioning (BIF) refers to a global IQ ranging from 71 to 84, and it represents a condition of clinical attention for its association with other disorders and its influence on the outcomes of treatments and, in general, quality of life and adaptation. Furthermore, its definition has changed over time causing a relevant clinical impact. For this reason, a systematic review of the literature on this topic can promote an understanding of what has been studied, and can differentiate what is currently attributable to BIF from that which cannot be associated with this kind of intellectual functioning. Using Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) criteria, we have conducted a review of the literature about BIF. The results suggest that this condition is still associated with mental retardation, and only a few studies have focused specifically on this condition.

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