A study to understand how women with ovarian cancer feel when having chemotherapy to control symptoms

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Cancer type:

Ovarian cancer

Status:

Results

Phase:

Other

This study looked at changes in symptoms of ovarian cancer during and after chemotherapy to control symptoms.

More about this trial

If your ovarian cancer comes back or continues to grow after chemotherapy, your doctor might offer you more chemotherapy to treat your symptoms. This can help maintain or improve your quality of life. This is palliative chemotherapy.

We know that chemotherapy can improve symptoms such as loss of appetite, tiredness and bowel problems. But researchers in this study were interested in how women felt during palliative chemotherapy for ovarian cancer. And if they felt their symptoms improved with treatment. 

They also wanted to find out if there were any factors that might predict how well women were likely to do on palliative chemotherapy.

Women who took part filled in questionnaires asking about their quality of life before, during and after treatment. They wanted to see if symptoms had improved and changed during this time.

They hoped that this information in future would help women and their health professionals make the best decisions about having palliative chemotherapy

 

Summary of results

The study team found women who stopped chemotherapy early had rated themselves low in:
  • global health status
  • role function
  • physical function
They also had a lot of ovarian cancer symptoms. 
 
Method
570 women took part in this international study. Of these, 545 women filled in questionnaires before starting palliative Open a glossary item chemotherapy. The questions asked about:
  • their general health
  • how they were feeling
  • how their cancer had affected their life, for example physically and emotionally
  • what symptoms they had
They filled in these questionnaires every 3 to 4 weeks before each chemotherapy treatment. 
 
Their doctor also looked at what symptoms these women had. 
 
There were 2 stages to this study. 
 
Results of stage 1
The team looked at how many women stopped chemotherapy early, within 8 weeks of starting. 
 
Of the 570 women who started chemotherapy, 110 women (19%) had stopped treatment. The reasons included:
  • their cancer got worse (46%)
  • they chose to stop (12%)
  • side effects (7%)
  • their doctor thought there was no longer a benefit (6%)
  • and other reasons including tiredness (11%)
During the first 8 weeks of chemotherapy some women died (18%).  
 
The team looked at the scores of the questionnaires and number of symptoms of the women had before starting chemotherapy. They found that those who had low scores and a high level of symptoms stopped their chemotherapy early. 
 
They also found that these women overall didn’t live as long as women who reported a high score on the questionnaires and had few symptoms. 
 
Measure of Ovarian Symptoms and Treatment (MOST)
In the 2nd stage the team tested a new questionnaire for women with ovarian cancer that could be used in clinical trials. It was aimed at being used in trials that looked at palliative chemotherapy to relieve the symptoms of ovarian cancer. 
 
The questions asked the women about:
  • their symptoms before chemotherapy
  • if the symptoms had improved or got worse after chemotherapy
  • what side effects of chemotherapy they had
673 women completed the questionnaire:
  • before starting palliative chemotherapy
  • between their 2nd and 3rd cycle of palliative chemotherapy 
Before starting chemotherapy 
The most common and severe symptoms reported were:
  • tummy (abdominal) swelling, bloating and feeling full
  • abdominal pain, discomfort and cramps
  • tiredness
  • loss of appetite
  • anxiety
After chemotherapy 
The team looked at the symptoms of the cancer and side effects of chemotherapy.
 
The symptoms that improved the most were:
  • abdominal swelling, bloating and feeling full
  • abdominal pain, discomfort and cramps
  • anxiety
7 symptoms or side effects got worse. 4 were due to the chemotherapy. These were:
  • hair loss
  • taste changes
  • sore mouth or throat
  • skin rash
The remaining 3 could have been due to the cancer or chemotherapy. 
These were:
  • tiredness
  • feeling sick
  • difficulty swallowing
Even though MOST was developed to use in clinical trials, the team also considered it was useful in the routine care of women with ovarian cancer. This was because it was quick and easy for women to complete. And for doctors to read and compare with previous assessments. 
 
Conclusions
The study team concluded the questionnaires could help improve the talks women and their doctors have about:
  • their cancer
  • having chemotherapy
  • possible outcomes
The Measure of Ovarian Symptoms and Treatment (MOST) accurately measures:
  • how bad the symptoms of ovarian cancer are
  • the side effects of treatment 
  • the benefit of chemotherapy
And that it can be used as a part of palliative care clinical trials. Further research is needed to find out how reliable it is. 
 
These questionnaires could also help with the communication between the doctor and patient about their cancer. And help these women make decisions if they are thinking about having chemotherapy. 
 
We have based this summary on information from the research team. The information they sent us has been reviewed by independent specialists (peer reviewed Open a glossary item) and published in a medical journal. The figures we quote above were provided by the trial team who did the research. We have not analysed the data ourselves.

Recruitment start:

Recruitment end:

How to join a clinical trial

Please note: In order to join a trial you will need to discuss it with your doctor, unless otherwise specified.

Please note - unless we state otherwise in the summary, you need to talk to your doctor about joining a trial.

Chief Investigator

Dr Anne Lanceley

Supported by

Target Ovarian Cancer
NIHR Clinical Research Network: Cancer
NIHR University College London Hospitals Biomedical Research Online
University College London Hospital 
University of Sydney

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Last review date

CRUK internal database number:

9977

Please note - unless we state otherwise in the summary, you need to talk to your doctor about joining a trial.

Charlie took part in a trial to try new treatments

A picture of Charlie

“I think it’s really important that people keep signing up to these type of trials to push research forward.”

Last reviewed:

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