Dietary Practices After Primary Treatment for Ovarian Cancer: A Qualitative Analysis From the OPAL Study

Johnston, Elizabeth A; Ekberg, Stuart; Jennings, Bronwyn; Jagasia, Nisha; Pols, Jolieke C. van der; Webb, Penelope M.

doi:10.1016/j.jand.2022.05.014

Cited by 7 publications

(4 citation statements)

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“…36 Among ovarian cancer survivors, depressive symptoms can contribute to a lack of energy or motivation to prepare healthy meals, a diminished interest in and enjoyment of food preparation and eating, and emotional or comfort eating. 37 These findings suggest that initiatives to promote cancer survivors' adherence to diet quality recommendations for cancer prevention should consider support for managing anxiety and depression. In a recent survey of women who had completed treatment for gynaecological cancer, anxiety and depression were ranked as one of the top post-treatment concerns, alongside diet.…”

Section: Discussionmentioning

confidence: 95%

“…Depression is also associated with changes in appetite, sustained fatigue, and apathy, 35 symptoms commonly reported by women with ovarian cancer 36 . Among ovarian cancer survivors, depressive symptoms can contribute to a lack of energy or motivation to prepare healthy meals, a diminished interest in and enjoyment of food preparation and eating, and emotional or comfort eating 37 …”

Section: Discussionmentioning

confidence: 99%

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Mental health and diet quality after primary treatment for ovarian cancer

Johnston,

Veenhuizen,

Ibiebele

et al. 2024

Nutrition & Dietetics

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AimsTo investigate anxiety and depression after primary treatment for ovarian cancer in relation to diet quality and intake.MethodsIn a cohort of women with ovarian cancer in Australia, levels of anxiety and depression (normal, subclinical, and clinical) were assessed using the Hospital Anxiety and Depression Scale at 9 months post‐diagnosis. Dietary intake was assessed using a validated food frequency questionnaire at 12 months post‐diagnosis and scored using the Healthy Eating Index 2015. Multinomial logistic regression and bivariate analyses were used to investigate relationships between levels of anxiety and depression and subsequent diet quality and intake of food groups.ResultsOf 595 women, anxiety and depression were identified among 128 (21%) and 80 (13%) women, respectively. Compared to women without anxiety or depression, women with subclinical anxiety (odds ratio = 0.49, 95% confidence interval: 0.25–0.98) and those with clinical depression (odds ratio = 0.25, 95% confidence interval: 0.07–0.93) were less likely to score in the highest quartile for diet quality. Separate adjustment for age, education, employment, disease stage, body mass index, and smoking status did not attenuate these associations. In bivariate analyses, women with subclinical anxiety were more likely to report higher intakes of sweet foods. Those with clinical depression were more likely to report lower intakes of orange vegetables and wholegrains, higher intakes of sweetened beverages, and not consume alcohol or soya foods.ConclusionsAnxiety or depression after primary treatment for ovarian cancer may be associated with poorer diet quality. Efforts to improve diet quality post‐treatment should consider support for mental health.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Mental health and diet quality after primary treatment for ovarian cancer

Johnston,

Veenhuizen,

Ibiebele

et al. 2024

Nutrition & Dietetics

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“…Fatigue, an outcome mentioned only in Greimel et al [ 22 ], is a significant predictor for quality of life as a substantial number of ovarian cancer patients experience fatigue [ 41 ]. Appetite loss, another mediator for quality of life, was reported by only one study [ 22 ] and was not included in our meta-analysis despite results from a study indicating how appetite loss impairs life for patients with cancer recurrence [ 42 ]. While insomnia was not included among outcomes for this study as only one study reported it [ 22 ], it has been established as a major factor contributing to a patient’s assessment of quality of life [ 43 ].…”

Section: Reviewmentioning

confidence: 99%

Comparison of the Efficacy of Cisplatin/Paclitaxel Versus Carboplatin/Paclitaxel in Improving Survival and Quality of Life in the Advanced Ovarian Cancer Patient Population: A Systematic Review and Meta-Analysis of Randomized Control Trials

Mansoor,

Shakil,

Jalal

et al. 2023

Cureus

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Ovarian cancer, being one of the prevalent gynecological cancers, warrants a therapy that’s both effective and well tolerated. After extensive drug testing, combination regimens with paclitaxel plus platinum-based agents such as cisplatin/carboplatin and taxanes, have shown promising results for advanced ovarian cancer. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to compare the efficacy of two treatment regimens for advanced ovarian cancer: cisplatin/paclitaxel and carboplatin/paclitaxel. PubMed (Medline), Science Direct, and Cochrane Library were searched from inception to March 2023. The meta-analysis included patients with histologically verified International Federation of Gynaecology and Obstetrics (FIGO) stages IIB to IV ovarian carcinoma who received either carboplatin/paclitaxel or cisplatin/paclitaxel. The primary outcomes were progression-free survival (PFS), overall survival (OS), quality of life (QOL), complete response rate (CRR), and partial response rate (PRR). The revised Cochrane Risk of Bias Tool 2.0 was used to assess the quality of the RCTs The five RCTs chosen for this statistical analysis consisted of a total of 2239 participants, with 1109 receiving paclitaxel/cisplatin for treatment and the remaining 1130 receiving carboplatin/paclitaxel. Among all included outcomes, these reported significant findings: QoL (p-value=0.0002), thrombocytopenia (p=<0.00001), neurological toxicity (p-value=0.003), nausea/vomiting (p-value=<0.00001), myalgia/arthralgia (p-value=0.02), and febrile neutropenia (p-value=0.01). We concluded that the carboplatin/paclitaxel doublet endows a better quality of life (QOL) to patients along with significantly fewer gastrointestinal and neurological toxicities when compared with the cisplatin/paclitaxel combination. However, the myelosuppressive effects of carboplatin/paclitaxel remain a point of concern and may require clinical management.

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“…The patient's self-management is further supported by their account of the underlying causes of their weight gain post-treatment. For example, they attribute weight gain to "emotional eating" (line 4), and eating more during winter (lines 6-8), while also explaining their capacity to selfmanage their weight: "…before I had all my treatment, I had gotten myself into a good kind of routine… doing a lot of walking, hiking, jogging, and I'd lost a bit of weight before then too" (lines [17][18][19][20][21]. Similar to the previous fragment, the patient's use of "you know" (lines 34 and 37) projects an aligning response to their narrative from the gyne-oncologist (see lines 36 and 39) [47].…”

Section: Diet Nutrition or Weight-related Talk Sustained But No Care-...mentioning

confidence: 99%

Discussing diet, nutrition, and body weight after treatment for gynecological cancer: a conversation analytic study of outpatient consultations

et al. 2023

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Purpose To generate direct observational evidence for understanding how diet, nutrition, and weight-related topics are discussed during follow-up after treatment for gynecological cancer, as recommended by survivorship care guidelines. Methods Conversation analysis of 30 audio-recorded outpatient consultations, involving 4 gyne-oncologists, 30 women who had completed treatment for ovarian or endometrial cancer, and 11 family members/friends. Results From 21 instances in 18 consultations, diet, nutrition, or weight-related talk continued beyond initiation if the issue raised was ostensibly relevant to the clinical activity being undertaken at the time. These instances led to care-related outcomes (i.e., general dietary recommendations, referral to support, behavior change counseling) only when the patient identified needing further support. Diet, nutrition, or weight-related talk was not continued by the clinician if it was not apparently related to the current clinical activity. Conclusions The continuation of diet, nutrition, or weight-related talk during outpatient consultations after treatment for gynecological cancer, and the subsequent delivery of care-related outcomes, depends on its immediate clinical relevance and the patient indicating needing further support. The contingent nature of these discussions means there can be missed opportunities for the provision of dietary information and support post-treatment. Implications for Cancer Survivors If seeking information or support for diet, nutrition, or weight-related issues post-treatment, cancer survivors may need to be explicit regarding their need for this during outpatient follow-up. Additional avenues for dietary needs assessment and referral should be considered to optimize the consistent delivery of diet, nutrition, and weight-related information and support after treatment for gynecological cancer.

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Dietary Practices After Primary Treatment for Ovarian Cancer: A Qualitative Analysis From the OPAL Study

Cited by 7 publications

References 46 publications

Mental health and diet quality after primary treatment for ovarian cancer

Mental health and diet quality after primary treatment for ovarian cancer

Comparison of the Efficacy of Cisplatin/Paclitaxel Versus Carboplatin/Paclitaxel in Improving Survival and Quality of Life in the Advanced Ovarian Cancer Patient Population: A Systematic Review and Meta-Analysis of Randomized Control Trials

Discussing diet, nutrition, and body weight after treatment for gynecological cancer: a conversation analytic study of outpatient consultations

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