Ovarian cancer survivors' acceptance of treatment side effects evolves as goals of care change over the cancer continuum

Women with ovarian cancer can have long overall survival and goals of treatment change over time from cure to remission to stable disease. We sought to determine whether survivors' acceptance of treatment side effects also changes over the disease continuum. Women with ovarian cancer completed...

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Bibliographic Details
Published in:Gynecologic oncology Vol. 146; no. 2; pp. 386 - 391
Main Authors: Frey, Melissa K., Ellis, Annie E., Koontz, Laura M., Shyne, Savannah, Klingenberg, Bernhard, Fields, Jessica C., Chern, Jing-Yi, Blank, Stephanie V.
Format: Journal Article
Language:English
Published: United States Elsevier Inc 01.08.2017
Subjects:
Adolescent
Adult
Aged
Alopecia - chemically induced
Alopecia - psychology
Antineoplastic Agents - adverse effects
Arthralgia - chemically induced
Arthralgia - psychology
Attitude to Health
Constipation - chemically induced
Constipation - psychology
Diarrhea - chemically induced
Diarrhea - psychology
Drug-Related Side Effects and Adverse Reactions - etiology
Drug-Related Side Effects and Adverse Reactions - psychology
Fatigue - chemically induced
Fatigue - psychology
Female
Gastroesophageal Reflux - chemically induced
Gastroesophageal Reflux - psychology
Hematology, Oncology and Palliative Medicine
Hospitalization
Humans
Memory Disorders - chemically induced
Memory Disorders - psychology
Middle Aged
Nausea - chemically induced
Nausea - psychology
Neoplasm Recurrence, Local - drug therapy
Neoplasm Recurrence, Local - psychology
Neoplasm Staging
Obstetrics and Gynecology
Ovarian Neoplasms - drug therapy
Ovarian Neoplasms - pathology
Ovarian Neoplasms - psychology
Pain - chemically induced
Pain - psychology
Patient Care Planning
Peripheral Nervous System Diseases - chemically induced
Peripheral Nervous System Diseases - psychology
Quality of Life
Remission Induction
Sexual Dysfunction, Physiological - chemically induced
Sexual Dysfunction, Physiological - psychology
Surveys and Questionnaires
Survivors - psychology
Vomiting - chemically induced
Vomiting - psychology
Young Adult
ISSN:0090-8258, 1095-6859, 1095-6859
Online Access:Get full text
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Summary:Women with ovarian cancer can have long overall survival and goals of treatment change over time from cure to remission to stable disease. We sought to determine whether survivors' acceptance of treatment side effects also changes over the disease continuum. Women with ovarian cancer completed an online survey focusing on survivors' goals and priorities. The survey was distributed through survivor networks and social media. Four hundred and thirty-four women visited the survey website and 328 (76%) completed the survey. Among participants, 141 (43%) identified themselves as having ever recurred, 119 (36%) were undergoing treatment at the time of survey completion and 86 (26%) had received four or more chemotherapy regimens. Respondents' goals of care were cure for 115 women (35%), remission for 156 (48%) and stable disease for 56 (17%). When asked what was most meaningful, 148 women (45%) reported overall survival, 135 (41%) reported quality of life and 40 (12%) reported progression-free survival. >50% of survivors were willing to tolerate the following symptoms for the goal of cure: fatigue (283, 86%), alopecia (281, 86%), diarrhea (232, 71%), constipation (227, 69%), neuropathy (218, 66%), arthralgia (210, 64%), sexual side effects (201, 61%), reflux symptoms (188, 57%), memory loss (180, 55%), nausea/vomiting (180, 55%), hospitalization for treatment side effects (179, 55%) and pain (169, 52%). The rates of tolerance for most symptoms decreased significantly as the goal of treatment changed from cure to remission to stable disease. Women with ovarian cancer willingly accept many treatment side effects when the goal of treatment is cure, however become less accepting when the goal is remission and even less so when the goal is stable disease. Physicians and survivors must carefully consider treatment toxicities and quality of life effects when selecting drugs for patients with incurable disease. •Women with ovarian cancer prioritize overall survival however also deeply value quality of life.•The expectation of “cure” drives women with ovarian cancer to accept many treatment toxicities.•Acceptance of treatment side effects wanes when the goal is remission and stable disease.
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ISSN:0090-8258
1095-6859
1095-6859
DOI:10.1016/j.ygyno.2017.05.029