Quality of life and mood in women receiving extensive chemotherapy for gynecologic cancer.

ABSTRACT

BACKGROUND: Quality of life (QOL) and mood were investigated among women who had received intensive chemotherapy for at least 1 year for advanced gynecologic cancers. Relationships of coping styles to QOL and mood in these patients also were examined. METHODS: Twenty-four patients who had been receiving chemotherapy continuously or intermittently for at least 1 year were recruited into the study. To control for the diagnosis of cancer and for prior hysterectomy, 24 age-matched early stage gynecologic cancer patients not receiving chemotherapy and assessed 1 year following diagnosis were examined as a comparison group. All subjects completed psychosocial assessments at a clinic visit. Medical information was retrospectively abstracted from patient charts. RESULTS: Decrements in physical, emotional, and functional well-being were reported by extensively treated patients, whereas social well-being and satisfaction with the relationship between doctor and patient were close to the norms of the comparison group. Extensively treated patients reported more fatigue and less vigor, but their depression and anxiety did not differ from early stage patients. Almost all extensively treated patients reported that their treatment had been worthwhile. Patients using avoidant coping reported poorer physical and emotional well-being, along with greater anxiety, depression, fatigue, and total mood disturbance. Those using active coping reported better social well-being, better relationships with their doctors, and less overall distress. CONCLUSIONS: This study indicates that gynecologic oncology patients extensively treated with chemotherapy experienced substantial decrements to quality of life, and yet treatment still was considered worthwhile by a majority of patients. Avoidant coping may be a particular risk factor for poor QOL and greater distress.