Ultimate fate

Long-Term Survival Among Histological Subtypes in Advanced Epithelial Ovarian Cancer: Population-Based Study Using the Surveillance, Epidemiology, and End Results Database

https://tinyurl.com/8udkpevw

 

         Information about the ultimate fate of long-term survivors after ovarian cancer is scarce. This retrospective study looks at a large number of women and matches their outcome to the type of ovarian cancer

         Data for more than 8000 women with stage III/IV ovarian cancer was collected from the SEER database. All these women were diagnosed during the period 2000-2014 and had survived 5 years or more after initial diagnosis.

         Despite their long-term survival, most of these women (80%) died from ovarian cancer, particularly the serous epithelial subtypes. For other subtypes it is less likely that women will die from ovarian cancer, with mucinous, endometrioid and clear cell cancer patients being half as likely to die from ovarian cancer. Other causes such as different cancers or cardiac disease become more important.

Live long

Conditional Relative Survival of Ovarian Cancer: A Korean National Cancer Registry Study

 

https://tinyurl.com/8t4h8eht

 

         It has been long thought that the chances of survival with ovarian cancer increase with time after initial diagnosis. This study, from Korea, provides an objective measure of how significant this improvement is.

         Retrospective review of almost 300 thousand women with ovarian cancer, of whom about two thirds died, showed that the most dangerous period was the first year; when about 12% of patients die. All the women were diagnosed during the period 1997-2016 .

         For each year after the first the odds of 5 years survival increase; from 61% initially to 84% after 5 years. Survival is longer in Korea than Australia due to the different mix of ovarian cancer, with endometrioid and clear cell cancer being more common. Knowing this will be useful in counselling women with ovarian cancer that, “Yes, things do get better”. 

A quiet death

Physician Variation in End-of-Life Care Among Women With Ovarian Cancer

https://tinyurl.com/2sydhrrz

 

         Ovarian cancer patients who are terminal should have access to a dignified and controlled death. So, why is this rarely the case? Sometimes the patient is unwilling to accept the inevitable and wishes to continue active treatment. More often this is physician driven.

         This retrospective study looked at Medicare benefits for more than 6,000 women during the period 2000-2016. These women were all aged more than 66; they had end-stage ovarian cancer.

         More than half of these women had aggressive end-of life treatment, with failure to start Palliative Care, admission to an ICU, an invasive procedure and chemotherapy during the last two weeks of life being the commonest. Analysis of the data showed a cluster of inappropriate care limited to some physicians. It is suggested that education of treating physicians would be the most effective means of improving end-of-life care.

A survivor. Why?

Attributions of survival and methods of coping of long-term ovarian cancer survivors: a qualitative study

https://tinyurl.com/4336wckr

 

         Surviving ovarian cancer is the exception, not the rule.  Which means that those who do survive are worthy of study, looking for practical and emotional routines that may be helpful to others.

         Ten-year survival is even more exceptional, with about 8% of Stage IV ovarian cancer patients living this long after diagnosis. This study looked at 22 women, trying to establish common strategies or tactics. Because of the scarcity of long-term survivors, the study is small and biased towards the white and wealthy.

         Unsurprisingly there was no feature common to all the women. A small number (5 of the 22) thought they were just lucky, none felt guilty. For those who had faith, it usually strengthened. A large majority (19 of the 22) attributed their survival to expert medical care. Many adopted a positive attitude to their adversity and made life-affirming choices, with changes to diet and exercise, to exclude negative feedback and seek control through greater knowledge.