OVQUEST - Life after the diagnosis and treatment of ovarian cancer - An international survey of symptoms and concerns in ovarian cancer survivors.

OBJECTIVES: Our aim was to investigate the prevalence and potential risk factors for persistent and troublesome physical and psychological symptoms following treatment for ovarian cancer (OC). METHODS: OvQuest is an international, internet-based, cross-sectional questionnaire which explored symptom burden and quality of life (QOL) after treatment for OC. Eligible women were aged 18 and over, diagnosed with OC at least 6 months previously and had received chemotherapy. Self-report data were collected including demographics, diagnosis and treatment, and standardised instruments for treatment-related toxicities, QOL, physical activity (PA) and supportive care needs. RESULTS: The survey included 1360 patients, of whom 421 (31%) had been treated for recurrent OC. 78% reported symptoms of peripheral neuropathy, 60% significant fatigue, 48% mood disturbance and 59% moderate-severe insomnia. Rates of fatigue, mood disorders, neuropathy and insomnia did not differ between women with or without recurrence. The majority of respondents were overweight or obese (high BMI, 59%) and 35% reported low PA. Low PA and high BMI were associated with poorer QOL scores and higher symptom burden across a range of domains. CONCLUSION: Women living after a diagnosis of OC report a substantial and ongoing symptom burden which impacts significantly on their quality of life across multiple domains. The reported associations between obesity, physical inactivity and poor QOL warrant prospective evaluation of lifestyle interventions to improve QOL.

Internal effect concentrations of organic substances for early life development of egg-exposed fish.

The present study investigates the likelihood that early life development of marine fish from contaminated areas is affected by maternally transferred persistent organic substances (POPs). The common sole (Solea solea) was used as model species. Fertilized eggs were exposed via the water until hatching, 6 days post fertilization. The newly hatched larvae were allowed to develop further under unexposed conditions until the end of the metamorphosis. Effects on the larvae were determined for the dioxin-like polychlorinated biphenyl PCB 126, the technical PCB-mixture Arochlor 1254, polybrominated diphenylethers (PBDEs), and hexabromocyclododecane (HBCD), for an artificial mixture of PCBs and PBDEs, and for 'field mixtures' extracted from sole from the North Sea and the contaminated Western Scheldt estuary. Effect levels were expressed as tissue concentrations in the newly hatched larvae at the end of the exposure period. Exposure to PCBs, PBDEs, and the artificial and field mixtures caused mortality that started to occur shortly after the larvae became free-feeding (10 days post fertilization) and continued to increase until the onset of metamorphosis, 15 days later. The effects induced by the field mixtures correlated well with the ΣPCB concentrations in the tissue of the exposed larvae. No indications were found for synergistic effects or for substantial contribution of other (unknown) substances in the field mixtures. HBCD did not induce toxic effects. As lipid normalized POP levels in fish eggs are in general comparable to the levels in the tissue of the female fish, fish tissue concentrations are indicative of the internal exposure of the developing larvae as a result maternally transferred POPs will occur in the field. In sole from the Western Scheldt estuary POP levels are about twenty times lower than the larval tissue concentration that produced 50 percent early life stage mortality. Levels in North Sea sole are an order of a magnitude lower. At more heavily contaminated sites negative effect of PCBs, especially of those with dioxin-like toxicity can be expected.