The management of anxiety and knowledge of serum CA-125 after an ovarian cancer diagnosis.
ABSTRACT This article describes the relationship among anxiety, distress, and serum CA-125 levels in women with ovarian cancer. Women's anxiety about monitoring their CA-125 levels during chemotherapy also is discussed. Data from a randomized trial including self-reported anxiety and emotional distress of women following surgery after a primary diagnosis of ovarian cancer, their recorded serum CA-125 levels, and knowledge about their CA-125 levels were analyzed. In the sample, 26 of 30 women had serum CA-125 levels above the normal range. At baseline, the sample had an elevated mean anxiety score and an elevated distress score. A moderate association was found between a high serum CA-125 level and a high anxiety score at baseline, but the finding was not statistically significant. A negative nonsignificant relationship was found between a high serum CA-125 level and distress at baseline. The qualitative analysis revealed two themes: anxiety and lack of knowledge of serum CA-125. Oncology nurses and nurse practitioners caring for these women should provide essential information and strategies that can help guide women with ovarian cancer through the journey of their disease.
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ABSTRACT: Advances in the treatment and early detection of ovarian cancer have led to gains in 5-year survival rates, with 52% of women diagnosed between 1992 and 1997 surviving 5 years or longer, compared with 41% of women diagnosed between 1983 and 1985. Although approximately 10%-15% of patients achieve and maintain complete responses to therapy, the remaining patients have persistent disease or eventually relapse. These patients will generally undergo a series of treatments, each associated with progressively shorter treatment-free intervals. Nevertheless, median survival of patients with recurrent ovarian cancer ranges from 12-24 months, demonstrating the chronic natural history of the disease. Advances in the treatment of ovarian cancer over the past decade have led to these improvements and have prompted oncologists to now view the management of patients with ovarian cancer as an ongoing, long-term challenge. This shift in approach has raised important new questions regarding patient management, including the need to define trigger points for initiating or changing treatment (e.g., sequential increases in serum cancer antigen 125 levels, appearance of symptoms, or cumulative toxicities), anticipation of impending treatment decision points, recognition that the overtreatment of patients early in the disease process may adversely affect future treatment opportunities, and a renewed emphasis on patient education and participation in decision-making. This review will discuss these important patient management issues and will conclude with case studies illustrating two distinct treatment strategies (planning and sequencing) for the long-term management of patients with ovarian cancer.The Oncologist 02/2002; 7 Suppl 5:20-8. · 4.54 Impact Factor
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ABSTRACT: A murine monoclonal antibody (OC125) has been developed that reacts with each of six epithelial ovarian carcinoma cell lines and with cryopreserved tumor tissue from 12 of 20 ovarian cancer patients. By contrast, the antibody does not bind to a variety of nonmalignant tissues, including adult and fetal ovary. OC125 reacts with only 1 of 14 cell lines derived from nonovarian neoplasms and has failed to react with cryostat sections from 12 nonovarian carcinomas.Journal of Clinical Investigation 12/1981; 68(5):1331-7. · 13.77 Impact Factor
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ABSTRACT: Epithelial ovarian cancer is the leading cause of death from gynecologic cancer in the United States. Although there has been a statistically significant improvement in 5-year survival, in 2005 more than 16,000 women were expected to die of this disease. To date, there is no reliable method to screen for ovarian cancer; therefore, the majority of cases are diagnosed with advanced disease. For early ovarian cancer, appropriate surgical staging and adjuvant chemotherapy for selected cases will result in survival rates of 90-95%. For advanced ovarian cancer, survival depends primarily on the success of the initial surgical procedure. Patients with complete cytoreduction to microscopic disease are often cured with adjuvant chemotherapy. There is growing evidence that these patients with microscopic residual disease are excellent candidates for intraperitoneal chemotherapy, and this mode of chemotherapy delivery may be their best opportunity for cure. Patients with optimal cytoreduction also may benefit from intraperitoneal chemotherapy, but cure is less likely. For patients with suboptimal cytoreduction, intravenous chemotherapy with a combination of carboplatin and paclitaxel is the current standard therapy. Most of these patients will experience recurrence of the cancer, with small chance of cure. Salvage chemotherapy is important in ovarian cancer because many patients respond to several salvage regimens. Because of the high response rate of ovarian cancer, even after relapse, it is probably better to consider 10-year survival as the ideal end point. Finally, new biologic agents, in combination with traditional surgery and chemotherapy, may result in further improvement in survival for patients with ovarian cancer.Obstetrics and Gynecology 07/2006; 107(6):1399-410. · 4.37 Impact Factor