Values and worries of ovarian cancer patients

Abstract

Introduction Older women with ovarian cancer (OC) are less likely to receive guideline concordant treatment. Differences in values and worries about treatment may explain why. Methods Women with OC in 2013–2015 were surveyed about values and worries at the time of initial treatment. Existing values (11 item, e.g., maintaining quality of life) and worries (12 items, e.g., treatment side effects) scales were adapted based on OC literature. Responses were very/somewhat/a little/not at all important or worried. Principal Component Analyses (PCA) identified groups of values and worries that best explained scales' variation. We examined proportions reporting very/somewhat important/worried on ≥1 item in each component by age (older ≥65 years, younger <65 years). Results Of 170 respondents, 42.3%were older. PCA components for values were: functional well-being (3 survey items, proportion of variance explained [PoVE] 26.3%), length of life and sexual functioning (3 items, PoVE 20.1%), attitudes (3 items, PoVE 14.2%), and not becoming a burden (2 items, PoVE 13.7%). PCA components for worries were: economic (4 items, PoVE 27.2%), uncertainty (6 items, PoVE 26.0%), and family impact (2 items, PoVE 16.3%). Older women were less likely to indicate very/somewhat worried to ≥1 item in the economic (51.4% vs 72.4%, p = 0.006), uncertainty (80.6% vs. 98.0%, p = 0.001), and family impact component (55.6% vs. 70.4%, p = 0.03). No other age differences were found. Conclusions While worry during OC treatment decision-making may differ across age groups, values do not. Research should assess how differences in worry might affect OC medical decision-making for older and younger women.

Quality of life versus length of life considerations in cancer patients: A systematic literature review

“…A study by Pisu and colleagues involving 170 ovarian cancer patients, showed that maintaining QoL and living as long as possible were both important. In women less than 65 years old, 96.9% felt longevity was important, and 95.9% felt that preserving QoL was important, compared with 87.5% and 90.3%, respectively, in the greater than 65‐year‐old age group . Stiggelbout and associates noted that when age was adjusted for in their statistical calculations, those in relationships and with children preferred longevity .…”

“…Despite the type of cancer, patients felt that QoL and LoL were equally important when considering treatment . In the study by Pisu and colleagues involving ovarian cancer, more than 90% stated that QoL and LoL were equally important . Another study by Jenkins and associates, involving participants with ovarian cancer showed that 57% felt LoL and QoL were equally important, 9% prioritized LoL, and 33% favored QoL .…”

“…In women less than 65 years old, 96.9% felt longevity was important, and 95.9% felt that preserving QoL was important, compared with 87.5% and 90.3%, respectively, in the greater than 65-year-old age group. 33 Stiggelbout and associates noted that when age was adjusted for in their statistical calculations, those in relationships and with children preferred longevity. 7 Derks and colleagues found that older patients were less likely to receive standard treatment, an effect that was more evident in those above the age of 80 years old.…”

“…41 In the study by Pisu and colleagues involving ovarian cancer, more than 90% stated that QoL and LoL were equally important. 33 Another study by Jenkins and associates, involving participants with ovarian cancer showed that 57% felt LoL and QoL were equally important, 9% prioritized LoL, and 33% favored QoL. 36 However, Donovan and colleagues demonstrated that women who had recurrent ovarian cancer, would opt for LoL, and choose to receive aggressive treatment, QoL was a secondary issue.…”

Treatment patterns and associated factors in patients with advanced epithelial ovarian cancer: a population-based study

“…Despite under-representation of elderly patients (≥65 years) in clinical trials,30 it has been reported that also for elderly women with advanced epithelial ovarian cancer, combined surgery and chemotherapy is the preferred treatment and is considered feasible 16. Nevertheless, a United States study among ovarian cancer patients demonstrated that older women reported being less worried about the consequences of cancer,31 which may perhaps influence treatment considerations in this age group. Moreover, older patients seem more focused on the quality of life rather than length of life 17 25…”