Quality of Life in Advanced Ovarian Cancer: Identifying Specific Concerns

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Abstract
Purpose: To identify issues affecting the quality of life (QoL) in women receiving palliative therapy for ovarian cancer. Methods: Twenty women with advanced recurrent ovarian cancer were interviewed to establish what issues affect QoL. All patients were receiving palliative chemotherapy or other palliative therapy in the department of Gynecologic Oncology at the Massachusetts General Hospital, and were felt to have a life expectancy of 1 year or less by best clinical estimate. Results: Twenty patients with an average age of 56.7 years participated. Psychosocial issues were more common than physical ones, and patients were more likely to mention issues that positively impact on QoL rather than those with a negative effect. Most patients noted that a sense of hope, enhanced appreciation for day to day life, and a strong support system had a significantly positive effect on QoL. Issues negatively impacting QoL included fear of their disease (90%) and concern for family and friends (100%), particularly children. Most common physical symptoms impacting QoL included fatigue (100%) and anorexia (55%). Conclusions: Little research has been done into QoL issues for ovarian cancer patients receiving palliative care. Available QoL studies tend to focus on the physical aspects of a disease or its treatment. This pilot study suggests that women with advanced, recurrent ovarian cancer feel that psychosocial issues play a greater role in determining QoL than do physical issues. Further QoL studies for these patients should include assessment of psychosocial realms. This information can then be used to design interventions to improve QoL.