"What doesn't kill you makes you stronger": an ovarian cancer survivor survey.

OBJECTIVES: This survey was designed to learn more about the physical health and quality of life of ovarian cancer survivors without known active disease and not on treatment. METHODS: Women with ovarian cancer without evidence of active disease, and not on treatment for at least 2 years, were recruited in Canada and the United States from university cancer clinics, community ovarian support groups, and a cancer survivor network newsletter and asked to complete an anonymous mail-back survey on their physical, psychological, social, and spiritual well-being. RESULTS: Two-hundred (67.5%) women responded. Their mean age was 55.3 years, 72.5% had children, and they had been diagnosed with ovarian cancer a mean of 7.2 years previously. Eighty-nine percent regarded their health as good or excellent, but 53.5% had current pain or discomfort. They reported better mental health and equivalent energy levels to the general population. Although 57% reported that their sex lives had been negatively affected by cancer and its treatment, their overall sense of loss relating to sexual functioning was moderate to low. However, women under age 55 years reported a greater sense of loss about sexual function and fertility (P = 0.001). Most women reported that their ovarian cancer experience had changed their views on life and relationships in an overwhelmingly positive way. CONCLUSION: Most ovarian cancer survivors, despite some symptoms, enjoyed good physical, psychological, social, and spiritual health. Specific concerns emerged about sexuality which should be addressed in patient education. Having survived a life-threatening illness, ovarian cancer survivors appear to have put other life difficulties into perspective, altered their priorities, and felt enriched by the experience. In general, these women showed impressive and inspiring resilience and reported good physical health and energy, excellent psychological health, and feelings of greater pleasure in life and personal relationships.

Ovarian carcinoma diagnosis.

BACKGROUND: Ovarian carcinoma often is called the "silent killer" because the disease usually is not detected until an advanced stage. The authors' goal was to evaluate preoperative symptoms and factors that may contribute to delayed diagnosis for women with ovarian carcinoma. METHODS: A two-page survey was distributed to 1500 women who subscribe to CONVERSATIONS!, a newsletter about ovarian carcinoma. Because the survey could be copied and given to other patients, 1725 surveys were returned from women in 46 states and 4 Canadian provinces. RESULTS: The median age of the surveyed women was 52 years, and 70% had Stage III or IV disease (International Federation of Gynecology and Obstetrics). When asked about symptoms before the diagnosis of ovarian carcinoma, 95% reported symptoms, which were categorized as abdominal (77%), gastrointestinal (70%), pain (58%), constitutional (50%), urinary (34%), and pelvic (26%). Only 11% of women with Stage I/II and 3% with Stage III/IV reported no symptoms before their diagnosis. Women who ignored their symptoms were significantly more likely to be diagnosed with advanced disease compared with those who did not (P = 0.002). The time required for a health care provider to make the diagnosis was reported as less than 3 months by 55%, but greater than 6 months by 26% and greater than 1 year by 11%. Factors significantly associated with delay in diagnosis were omission of a pelvic exam at first visit; having a multitude of symptoms; being diagnosed initially with no problem, depression, stress, irritable bowel, or gastritis; not initially receiving an ultrasound, computed tomography, or CA 125 test; and younger age. The type of health care provider seen initially, insurance, and specific symptoms did not correlate with delayed diagnosis. CONCLUSIONS: This large national survey confirms that the majority of women with ovarian carcinoma are symptomatic and frequently have delays in diagnosis.

Quality of life in women with ovarian cancer.

Despite growing interest in quality of life (QOL) as an important variable in nursing and health care, little research focuses on QOL in women with ovarian cancer (OVCA). The purpose of this study was to examine QOL in OVCA survivors. The convenience sample consisted of 152 women in all disease stages. Quantitative data were collected using the QOL-Cancer Survivors tool and a demographic sheet. Qualitative data were collected by asking participants to write their definitions and experiences of QOL since their diagnosis. Reliability and validity of all data and findings were established. Findings reveal that QOL is moderately high for this group of cancer survivors, despite some specific negative facets of the illness and treatment experience. Qualitative analysis elaborates the four domains of Ferrell's QOL model: physical, psychological, social, and spiritual well-being. Qualitative data also reflect the complexity of the cancer experience.