Symptoms Relevant to Surveillance for Ovarian Cancer

Abstract

To examine how frequently and confidently healthy women report symptoms during surveillance for ovarian cancer. A symptoms questionnaire was administered to 24,526 women over multiple visits accounting for 70,734 reports. A query of reported confidence was included as a confidence score (CS). Chi square, McNemars test, ANOVA and multivariate analyses were performed. 17,623 women completed the symptoms questionnaire more than one time and >9500 women completed it more than one four times for >43,000 serially completed questionnaires. Reporting ovarian cancer symptoms was ~245 higher than ovarian cancer incidence. The positive predictive value (0.073%) for identifying ovarian cancer based on symptoms alone would predict one malignancy for 1368 cases taken to surgery due to reported symptoms. Confidence on the first questionnaire (83.3%) decreased to 74% when more than five questionnaires were completed. Age-related decreases in confidence were significant (p < 0.0001). Women reporting at least one symptom expressed more confidence (41,984/52,379 = 80.2%) than women reporting no symptoms (11,882/18,355 = 64.7%), p < 0.0001. Confidence was unrelated to history of hormone replacement therapy or abnormal ultrasound findings (p = 0.30 and 0.89). The frequency of symptoms relevant to ovarian cancer was much higher than the occurrence of ovarian cancer. Approximately 80.1% of women expressed confidence in what they reported.

Longitudinal Change in Symptom Clusters in Patients With Ovarian Cancer

“…In comparison with a single symptom, the symptoms within and among clusters may exert synergistic and intensifying effects (Hadi et al, 2008). The consequence of symptom clusters is not simply the cumulative effect of single symptoms but rather a doubling trend, which may eventually affect patients' quality of life (QoL), functional status, and prognosis (Ore et al, 2017; Smith et al, 2018).…”

“…The importance of the various types of symptom distress in patients with ovarian cancer differs at different stages of the treatment, and the occurrence of symptoms reveals stage-specific characteristics (Ferrell et al, 2003). Most studies of ovarian-cancer-related symptoms in patients have focused on a specific time point during treatment (Ore et al, 2017; Smith et al, 2018), especially for patients with specific disease stage and different age distribution (Kim et al, 2018). However, only a few longitudinal studies have been conducted in China to assess the symptoms of patients with ovarian cancer before surgery, after surgery, and at the initial stage of chemotherapy.…”

“Lower abdominal pains, as if I was being squeezed…in a clamp”: A Qualitative Analysis of Symptoms, Patient-Perceived Side Effects and Impacts of Ovarian Cancer

“…Early symptoms of ovarian cancer are subtle and lack predictive value for identifying the disease [1]. Most women with ovarian cancer are first diagnosed with established disease, when the 5-year survival rate is less than 30% [2,3].…”

10<em>H</em>-3,6-Diazaphenothiazine induces G₂/M phase cell cycle arrest and caspase-dependent apoptosis and inhibits cell invasion of A2780 ovarian carcinoma cells through the regulation of NF-&kappa;B and (BIRC6-XIAP) complexes

“… 2 , 3 Ovarian cancer is highly associated in female with BRCA1 and BRCA2 mutation, either inherited or acquired, although it is also associated with other risk factors such as obesity, late menopause, cigarette smoking, and nulliparity. 4 – 8 The most common type of ovarian cancer is derived from epithelial cells through a series of mutation on tumor suppressor genes (such as PTEN , BRCA1 , BRCA2 , and p53 ), which result from silencing of the genes; 4 – 6 meanwhile mutation of oncogenes (such as Bcl-2, EFGR, and VEGF) leads to over-activation, thus making the cancer cells autonomous on self-growing and providing resistance to cell death signals or escape from cell cycle checkpoints, ability to invade, and metastasis to distant location which further yields the occurrence of secondary tumor. 9 , 10 As mentioned, ovarian cancer cells are reported with high invasion and metastasis rate, because of high activities from NF-κB gene and subsequent complex formation by several survival and proliferation factors, such as X-linked inhibitor of apoptosis (XIAP) and baculoviral inhibitor of apoptosis repeat-containing gene (BIRC) families (mainly BIRC 1–6).…”