Barbara Boughton

May 21, 2012

May 21, 2012 (San Diego, California) — Ovarian cancer survivors continue to have psychological distress even 5 or more years after completing their treatment and have undiagnosed anxiety about the possibility of recurrence, according to researchers here at the American Congress of Obstetricians and Gynecologists (ACOG) 60th Annual Clinical Meeting.

In the study, researchers led by Arvind Bakhru, MD, MPH, University of Michigan, Ann Arbor, surveyed women who had been diagnosed and treated for ovarian cancer at the University of Michigan during a 10-year period (from 1999 to 2009). All the women had been treated more than 6 months before the initiation of the survey, and some had been in remission for more than 5 years. Each woman completed the Fear of Cancer Recurrence Inventory (FCRI), a questionnaire that examines triggers for recurrence fears, severity of fears, psychological distress, and coping strategies.

Researchers compared results from the FCRI for women who had received treatment less than 3 years before the survey, those who had treatment between 3 and 5 years before the survey, and those in remission for more than 5 years.

Results indicated that although most women discussed their recurrence risk with their oncologist (63.9%), only 13.1% reported having anything about recurrence risk written down for them (13.1%). Although the chance of recurrence declines significantly with long-term remission, even women who had survived for 5 years or more years reported experiencing psychological distress years later.

Few women confided even to their family members or friends about their fears. More than 59% of survey respondents said they do not talk with others about their fears of recurrence, and only 6.3% had ever joined a support group for women with ovarian cancer.

Psychological distress, severity of anxiety, and functional impairment all improved with time among the women who took the survey. However, triggers for anxiety, reassurance about recurrence, and coping strategies were not significantly different among those who had been in remission for less than 3 years, those treated between 3 and 5 years before the survey, or even women in remission 5 years after treatment, according to the researchers.

"Ongoing anxiety and depression in our ovarian cancer survivor population is definitely an unmet need," commented Vivian von Gruenigen, MD, chair of obstetrics and gynecology and a specialist in gynecologic oncology at Summa Health System in Akron, Ohio.

"The University of Michigan researchers get kudos for getting such a high response rate to their survey (49%), which is higher than in similar studies. But they also used just one tool for measuring anxiety, when there are others available as well," Dr. von Gruenigen said.

When patients experience anxiety and depression after cancer treatment, they often don't mention these feelings to their doctors, and physicians don't always prompt these conversations, Dr. von Gruenigen said.

"It's worth noting that a subset of the ovarian cancer patients did engage with support in the healthcare system, and these patients tended to do well. But the study points out that there is a psychosocial aspect to ovarian cancer, including undiagnosed anxiety and depression," she added.

Dr. Bakhru and Dr. von Gruenigen have disclosed no relevant financial relationships.

American Congress of Obstetricians and Gynecologists (ACOG) 60th Annual Clinical Meeting. Abstract #84. Presented May 8, 2012.

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