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Controlled Study of Fatigue, Quality of Life, and Somatic and Mental Morbidity in Epithelial Ovarian Cancer Survivors: How Lucky Are the Lucky Ones?

Astrid H. Liavaag, Anne Dørum, Sophie D. Fosså, Claes Tropé, Alv A. Dahl

From the Department of Gynecology, Sorlandet Hospital, Arendal; and the Department of Gynecological Oncology and The Cancer Clinic, Department of Clinical Cancer Research, Rikshospitalet-Radiumhospitalet, University of Oslo, Oslo, Norway

Address reprint requests to Astrid H. Liavaag, MD, Department of Gynecology, Sorlandet Hospital HF, Serviceboks 605, 4809 Arendal, Norway; e-mail: astrid.liavaag{at}sshf.no

Purpose: There are few studies of somatic and mental morbidity in epithelial ovarian cancer survivors (EOCSs). The aim of this controlled, cross-sectional study was to explore fatigue, quality of life (QOL), and somatic and mental morbidity in EOCSs.

Patients and Methods: Among 287 EOCSs treated according to protocols at The Norwegian Radium Hospital between 1977 and 2003, 189 patients (66%) participated. Information was collected by a questionnaire containing demographic and morbidity items and self-rating scales. Internal comparisons of various subgroups of EOCSs were performed, and EOCSs were compared with age-adjusted controls from the general population.

Results: Minimal differences were observed relating to somatic and mental morbidity, fatigue, and QOL between EOCSs with and without relapse, long or short follow-up time, and prognostic index status. Chronic fatigue was found in 22% (95% CI, 16% to 28%), and only body image was significantly associated with chronic fatigue in multivariable analyses. EOCSs showed significantly more somatic and mental morbidity, somatic complaints, use of medications, and use of health care services than controls. The levels of anxiety and fatigue were also significantly higher in EOCSs than in controls, whereas the levels of depression and of several QOL dimensions were lower. The prevalence of chronic fatigue was 12% among controls.

Conclusion: EOCSs had more somatic and mental morbidity, more fatigue, poorer QOL, and used more medication and health services than controls. Minimal differences were observed between various EOCS subgroups. Health care professionals should try to improve and be attentive to the health of EOCSs.

Supported by The Norwegian Foundation for Health and Rehabilitation (Grant No. 55002/001) through the Norwegian Cancer Society (A.H.L.). The Nord-Trøndelag Health Study (the HUNT study) is a collaboration between HUNT Research Centre, Faculty of Medicine, Norwegian University of Science and Technology (Verdal), Norwegian Institute of Public Health, and Nord-Trøndelag County Council.

Presented in part at the annual meeting of the Norwegian Gynecological Association, September 1, 2006, Oslo, Norway.

Authors' disclosures of potential conflicts of interest and author contributions are found at the end of this article.

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