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

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:

18/03/2013

Recruitment end:

31/12/2014

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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

If you have questions about the trial please contact our cancer information nurses

Freephone 0808 800 4040

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