Patients' and oncologists' views on the treatment and care of advanced ovarian cancer in the UK: results from the ADVOCATE study

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Jenkins, V ; Catt, S ; Banerjee, S ; Gourley, C ; Montes, A ; Solis-Trapala, I ; Monson, K ; Fallowfield, L (2013)
  • Publisher: Nature Publishing Group
  • Journal: British Journal of Cancer (issn: 0007-0920, vol: 108, pp: 2,264-2,271)
  • Related identifiers: doi: 10.1038/bjc.2013.223, pmc: PMC3681025
  • Subject: oncologists' views | maintenance therapy | Patient Acceptance of Health Care | Cancer Research | Oncology | advanced ovarian cancer | Medical Oncology | Ovarian Neoplasms | Physician's Practice Patterns | Survival Rate | female | Clinical Study | Great Britain | Middle Aged | Questionnaires | patients' views | Disease-Free Survival | chemotherapy treatments | supportive care | /dk/atira/pure/subjectarea/asjc/2700/2730 | /dk/atira/pure/subjectarea/asjc/1300/1306 | Quality of Life | Humans | Male | R1

Background:Most patients presenting with advanced ovarian cancer (AOC) eventually relapse. Symptom palliation, maintenance of quality of life (QoL) and prolongation of life are primary therapeutic goals.Methods:Sixty-six UK oncologists completed an online survey about AOC management. Two hundred and two patients were interviewed about care, treatment experiences and expectations.Results:Prior to diagnosis, 34% (69 out of 202) of women had 3 symptoms associated with AOC. Twenty-one per cent (43 out of 202) thought poor symptom recognition by general practitioners (GPs) delayed diagnosis. Amelioration of side effects experienced was variable, for example, only 54% (68 out of 127) distressed by alopecia had received sufficient information about it. Clinicians were asked 'What minimum gain in progression-free survival (PFS) would make you feel it worthwhile to offer maintenance therapy?'; 48% (24 out of 50) indicated 5-6 months, but 52% (26 out of 50) believed patients would find PFS of 3-4 months acceptable. When patients were presented with hypothetical scenarios, 33% (52 out of 160) would require 1-2 months extra life, 6% (10 out of 160) 3-4 months, 31% (49 out of 160) 5-6 months, and 31% (49 out of 160) 7 months. However, 86% (173 out of 202) would accept treatment that improved QoL without prolongation of life. When asked what was most important, 33% (67 out of 201) said QoL, 9% (19 out of 201) length of life and 57% (115 out of 201) said both were equally important.Conclusion:Clinicians' and patients' experiences, expectations and priorities about OC management may differ.British Journal of Cancer advance online publication 7 May 2013; doi:10.1038/bjc.2013.223
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