Background: Ovarian cancer accounts for 4% of cancers occurring in women and ranks first in gynecological cancer mortality. Maintaining and improving quality of life is an important goal of cancer treatment. The toxicities of cancer treatment particularly chemotherapy can impact an individual’s wellbeing. Objective: Assessment of quality of life among ovarian cancer patients receiving chemotherapy. Method: A descriptive study was conducted among 202 patients with ovarian cancer treated at the National Institute of Cancer Research and Hospital in Bangladesh. Ethical approval was received from the ethics committee of NICRH. Data was collected using the EORTC QLQC30 questionnaire and the ovarian cancer specific EORTC QOL OV-28 module. Functional, symptomatic and global variables were scored and analyzed by SPSS. Multiple linear regressions determined the effects of predictor variables and correlation of the global health status with other variables. Results: 48.6% of patients were ages 41 to 50 years. The mean score of global health status was 55.77. Deteriorating emotional function, distressing physical and psychological symptoms, sexual dysfunction and financial difficulties adversely affect the quality of life. Their correlation with global health status was strongly significant (P value < 0.05). Fatigue (r value - 0.604; p < 0.05) loss of appetite (r value - 0.442; p < 0.05), insomnia (r value - 0.339; p < 0.05), dyspnea (r value - 0.377; p < 0.05), heartburn (r value - 0.369; p < 0.05), and alopecia (r value - 0.262; p < 0.05) were negatively associated with QOL. Conclusion: The overall quality of life among the ovarian cancer patients receiving chemotherapy is low. Increasing knowledge in this area will help clinicians to optimize patient management. Interventions should focus on both physical and psychological and sexual health issues that adversely affect the quality of life .
KeywordsQuality of LifeEORTC QLQ C30EORTC QOL OV-28Ovarian CancerChemotherapyBangladesh
Bray, F., Ferlay, J., Soerjomataram, I., Siegel, R.L., Torre, L.A. and Jemal, A. (2018) Global Cancer Statistics 2018: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA: A Cancer Journal for Clinicians, 68, 394-424. https://doi.org/10.3322/caac.21492
Howlader, N., Noone, A.M., Krapcho, M., Miller, D., Brest, A., Yu, M., Ruhl, J., Tatalovich, Z., Mariotto, A., Lewis, D.R., Chen, H.S., Feuer, E.J. and Cronin, K.A. (2020) SEER Cancer Statistics Review, 1975-2017. National Cancer Institute, Bethesda, MD. https://seer.cancer.gov/csr/1975_2017/
Coburn, S.B., Bray, F., Sherman, M.E. and Trabert, B. (2017) International Patterns and Trends in Ovarian Cancer Incidence, Overall and by Histologic Subtype. International Journal of Cancer, 140, 2451-2460. https://doi.org/10.1002/ijc.30676
Torre, L.A., Trabert, B., DeSantis, C.E., et al. (2018) Ovarian Cancer Statistics. CA: A Cancer Journal for Clinicians, 68, 284-296. https://doi.org/10.3322/caac.21456
Siegel, R.L., Miller, K.D. and Jemal, A. (2020) Cancer Statistics, 2020. CA: A Cancer Journal for Clinicians, 70, 7-30. https://doi.org/10.3322/caac.21590
World Health Organization (2020) WHOQOL: Measuring Quality of Life. https://www.who.int/healthinfo/survey/whoqol-qualityoflife/en/
Testa, M.A. and Simonson, D.C. (1996) Assessment of Quality-of-Life Outcomes. The New England Journal of Medicine, 334, 835-840. https://doi.org/10.1056/NEJM199603283341306
Wilson, I.B. and Cleary, P.D. (1995) Linking Clinical variables with Health-Related Quality of Life: A Conceptual Model of Patient Outcomes. JAMA, 273, 59-65. https://doi.org/10.1001/jama.1995.03520250075037
Guyatt, G.H., Feeny, D.H. and Patrick, D.L. (1993) Measuring Health-Related Quality of Life. Annals of Internal Medicine, 118, 622-629. https://doi.org/10.7326/0003-4819-118-8-199304150-00009
Basch, E., Deal, A.M., Dueck, A.C., Scher, H.I., Kris, M.G., Hudis, C. and Schrag, D. (2017) Overall Survival Results of a Trial Assessing Patient-Reported Outcomes for Symptom Monitoring During Routine Cancer Treatment. JAMA, 318, 197-198. https://doi.org/10.1001/jama.2017.7156
Hwang, T.J. and Gyawali, B. (2019) Association between Progression-Free Survival and Patients’ Quality of Life in Cancer Clinical Trials. International Journal of Cancer, 144, 1746-1751. https://doi.org/10.1002/ijc.31957
Parmar, M.K.B., Ledermann, J.A., Colombo, N., du Bois, A., Delaloye, J.-F., Kristensen, G.B., Wheeler, S., Swart, A.M., Qian, W., Torri, V., Floriani, I., Jayson, G., Lamont, A., Tropé, C., ICON and AGO Collaborators (2003) Paclitaxel plus Platinum-Based Chemotherapy versus Conventional Platinum-Based Chemotherapy in Women with Relapsed Ovarian Cancer: The ICON 4/AGO-OVAR-2.2 Trial. Lancet, 361, 2099-2106. https://doi.org/10.1016/S0140-6736(03)13718-X
Awadalla, A.W., Ohaeri, J.U., Gholoum, A., Khalid, A.O.A., Hamad, H.M.A. and Jacob, A. (2007) Factors Associated with Quality of Life of Outpatients with Breast Cancer and Gynecologic Cancers and Their Family Caregivers: A Controlled Study. BMC Cancer, 7, Article No. 102. https://doi.org/10.1186/1471-2407-7-102
Sun, C.C., Ramirez, P.T. and Bodurka, D.C. (2007) Quality of Life for Patients with Epithelial Ovarian Cancer. Nature Clinical Practice Oncology, 4, 18-29. https://doi.org/10.1038/ncponc0693
Setia, M.S. (2016) Methodology Series Module 5: Sampling Strategies. Indian Journal of Dermatology, 61, 505-509. https://doi.org/10.4103/0019-5154.190118
Aaronson, N.K., Ahmedzai, S., Bergman, B., Bullinger, M., Cull, A., Duez, N.J., Filiberti, A., Flechtner, H., Fleishman, S.B., de Haes, J.C.J.M., Kaasa, S., Klee, M.C., Osoba, D., Razavi, D., Rofe, P.B., Schraub, S., Sneeuw, K.C.A., Sullivan, M. and Takeda, F. (1993) The European Organisation for Research and Treatment of Cancer QLQ-C30: A Quality-of-Life Instrument for Use in International Clinical Trials in Oncology. Journal of the National Cancer Institute, 85, 365-376. https://doi.org/10.1093/jnci/85.5.365
Fayers, P.M., Aaronson, N.K., Bjordal, K., Groenvold, M., Curran, D., Bottomley, A. and, on behalf of the EORTC Quality of Life Group (2001) The EORTC QLQ-C30 Scoring Manual. 3rd Edition, European Organization for Research and Treatment of Cancer, Brussels.
PEW Research Center Global Attitudes & Trends (2014) Emerging and Developing Economies Much More Optimistic than Rich Countries about the Future. https://www.pewresearch.org/global/2014/10/09/emerging-and-developing-economies-much-more-optimistic-than-rich-countries-about-the-future/
McCabe, C., Begley, C., Collier, S. and McCann, S. (2008) Methodological Issues Related to Assessing and Measuring Quality of Life in Patients with Cancer: Implications for Patient Care. European Journal of Cancer Care, 17, 56-64. https://doi.org/10.1111/j.1365-2354.2007.00809.x
Heydarnejad, M.S., Hassanpour, D.A. and Solati, D.K. (2011) Factors Affecting Quality of Life in Cancer Patients Undergoing Chemotherapy. African Health Sciences, 11, 266-270.
Pervin, S., Ruma, F.I., Rahman, K., Ferdous, J., Ara, R., Sayed, M.M.A. and Goodman, A. (2019) Adjuvant Hysterectomy in Patients with Residual Disease after Radiation for Locally Advanced Cervical Cancer: A Prospective Longitudinal Study. Journal of Global Oncology, 5, 1-7. https://doi.org/10.1200/JGO.18.00157
Osoba, D., Zee, B., Pater, J., et al. (1994) Psychometric Properties and Responsiveness of the EORTC Quality of Life Questionnaire (QLQ-C30) in Patients with Breast, Ovarian and Lung Cancer. Quality of Life Research, 3, 353-364. https://doi.org/10.1007/BF00451727
Coleridge, S.L., Bryant, A., Lyons, T.J., Goodall, R.J., Kehoe, S. and Morrison, J. (2019) Chemotherapy versus Surgery for Initial Treatment in Advanced Ovarian Epithelial Cancer. Cochrane Database of Systematic Reviews, 2019, Article No. CD005343. https://doi.org/10.1002/14651858.CD005343.pub4
Yang, L.Y., Manhas, D.S., Howard, A.F. and Olson, R.A. (2018) Patient-Reported Outcome Use in Oncology: A Systematic Review of the Impact on Patient-Clinician Communication. Support Care in Cancer, 26, 41-60. https://doi.org/10.1007/s00520-017-3865-7
Holzner, B., Kemmler, G., Meraner, V., et al. (2003) Fatigue in Ovarian Carcinoma Patients: A Neglected Issue? Cancer, 97, 1564-1572. https://doi.org/10.1002/cncr.11253
Payne, J.K. (2002) The Trajectory of Fatigue in Adult Patients with Breast and Ovarian Cancer Receiving Chemotherapy. Oncology Nursing Forum, 29, 1334-1340. https://doi.org/10.1188/02.ONF.1334-1340
Teng, F.F., Kalloger, S.E., Brotto, L. and McAlpine, J.N. (2014) Determinants of Quality of Life in Ovarian Cancer Survivors: A Pilot Study. Journal of Obstetrics and Gynaecology Canada, 36, 708-715. https://doi.org/10.1016/S1701-2163(15)30513-2
Sehati Shafaee, F., Mirghafourvand, M., Harischi, S., Esfahani, A. and Amirzehni, J. (2018) Self-Confidence and Quality of Life in Women Undergoing Treatment for Breast Cancer. Asian Pacific Journal of Cancer Prevention, 19, 733-740. https://dx.doi.org/10.22034/APJCP.2018.19.3.733
Annunziata, M.A., Muzzatti, B., Mella, S. and Bidoli, E. (2013) Fatigue, Quality of Life, and Mood States during Chemotherapy in Italian Cancer Patients. Tumori Journal, 99, e28-e33. https://doi.org/10.1177/030089161309900129
Li, Q., Lin, Y., Qiu, Y., Gao, B. and Xu, Y. (2014) The Assessment of Health-Related Quality of Life and Related Factors in Chinese Elderly Patients Undergoing Chemotherapy for Advanced Cancer: A Cross-Sectional Study. European Journal of Oncology Nursing, 18, 425-435. https://doi.org/10.1016/j.ejon.2014.03.005
Loprinzi, C.L., Lachetti, C., Bleeker, J., Cavaletti, G., Chauhan, C., Hertz, D.L., Kelley, M.R., Lavino, A., Lustberg, M.B., Paice, J.A., Schneider, B.P., Lavoie Smith, E.M., Smith, M.L., Smith, T.J., Wagner-Johnston, N. and Hershman, D.L. (2020) Prevention and Management of Chemotherapy-Induced Peripheral Neuropathy in Survivors of Adult Cancers: ASCO Guideline Update. Journal of Clinical Oncology, 38, 3325-2248. https://doi.org/10.1200/JCO.20.01399
Ocean, A.J. and Vahdat, L.T. (2004) Chemotherapy-Induced Peripheral Neuropathy: Pathogenesis and Emerging Therapies. Supportive Care in Cancer, 12, 619-625. https://doi.org/10.1007/s00520-004-0657-7
Salehifar, E., Janbabaei, G., Hendouei, N., Alipour, A., Tabrizi, N. and Avan, R. (2020) Comparison of the Efficacy and Safety of Pregabalin and Duloxetine in Taxane-Induced Sensory Neuropathy: A Randomized Controlled Trial. Clinical Drug Investigation, 40, 249-257. https://doi.org/10.1007/s40261-019-00882-6
Tschernicovsky, R., Philp, L. and Goodman, A. (2019) Chemotherapy-Induced Cognitive Decline Moving from the Mechanistic Debate towards Prevention and Treatment—A Clinical Review. Journal of Cancer Therapy, 10, 985-1012. https://doi.org/10.4236/jct.2019.1012084
Warr, D.G. (2008) Chemotherapy and Cancer Related Nausea and Vomiting. Currrent Oncology, 15, S4-S9. https://doi.org/10.3747/co.2008.171
Gibson, R.J. and Keefe, D.M.K. (2006) Cancer Chemotherapy-Induced Diarrhoea and Constipation: Mechanisms of Damage and Prevention Strategies. Supportive Care in Cancer, 14, Article No. 890. https://doi.org/10.1007/s00520-006-0040-y
Jayde, V., Boughton, M. and Blomfield, P. (2013) The Experience of Chemotherapy-Induced Alopecia for Australian Women with Ovarian Cancer. European Journal of Cancer Care, 22, 503-512. https://doi.org/10.1111/ecc.12056
Lemieux, J., Maunsell, E. and Provencher, L. (2008) Chemotherapy-Induced Alopecia and Effects on Quality of Life among Women with Breast Cancer: A Literature Review. Psycho-Oncology, 17, 317-328. https://doi.org/10.1002/pon.1245
van Alphen, K., Versluis, A., Dercksen, W., de Haas, H., Lugtenberg, R., Tiemensma, J., Kroep, J., Broadbent, E., Kaptein, A.A. and van den Hurk, C. (2020) Giving a Face to Chemotherapy-Induced Alopecia: A Feasibility Study on Drawings by Patients. Asia-Pacific Journal of Oncology Nursing, 7, 218-224. https://doi.org/10.4103/apjon.apjon_8_20
Julkunen, J., Gustavsson-Lilius, M. and Hietanen, P. (2009) Anger Expression, Partner Support, and Quality of Life in Cancer Patients. Journal of Psychosomatic Research, 66, 235-244. https://doi.org/10.1016/j.jpsychores.2008.09.011
Liavaag, A.H., Dorum, A., Bjoro, T., et al. (2008) A Controlled Study of Sexual Activity and Functioning in Epithelial Ovarian Cancer Survivors. A Therapeutic Approach. Gynecologic Oncology, 108, 348-354. https://doi.org/10.1016/j.ygyno.2007.10.009
Thranov, I. and Klee, M. (1994) Sexuality among Gynecologic Cancer Patients—A Cross-Sectional Study. Gynecologic Oncology, 52, 14-19. https://doi.org/10.1006/gyno.1994.1004
Meraner, V., Gamper, E.-M. and Grahmann, A., et al. (2012) Monitoring Physical and Psychosocial Symptom Trajectories in Ovarian Cancer Patients Receiving Chemotherapy. BMC Cancer, 12, Article No. 77. https://doi.org/10.1186/1471-2407-12-77
Mayer, S., Iborra, S., Grimm, D., Steinsiek, L., Mahner, S., Bossart, M., Woelber, L., Voss, P.J., Gitsch, G. and Hasenburg, A. (2019) Sexual Activity and Quality of Life in Patients after Treatment for Breast and Ovarian Cancer. Archives of Gynecology and Obstetrics, 299, 191-201. https://doi.org/10.1007/s00404-018-4922-2
Kim, S.I., Lee, Y., Lim, M.C., Joo, J., Park, K., Lee, D.O. and Park, S.Y. (2015) Quality of Life and Sexuality Comparison between Sexually Active Ovarian Cancer Survivors and Healthy Women. Journal of Gynecologic Oncology, 26, 148-154. https://doi.org/10.3802/jgo.2015.26.2.148
Shao, Z.Y., Zhu, T., Zhang, P., Wen, Q., Li, D. and Wang, S.H. (2017) Association of Financial Status and the Quality of Life in Chinese Women with Recurrent Ovarian Cancer. Health and Quality of Life Outcomes, 15, Article No. 144. https://doi.org/10.1186/s12955-017-0714-9
Bornstein, M.H., Jager, J. and Putnick, D.L. (2017) Sampling in Developmental Science: Situations, Shortcomings, Solutions, and Standards. Developmental Review, 33, 357-370. https://doi.org/10.1016/j.dr.2013.08.003