title: Patients' and oncologists' views on the treatment and care of advanced ovarian cancer in the U.K.: results from the ADVOCATE study.
abstract: 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 U.K. 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 > or =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) > or =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.
  
  
  CONCLUSIONS
  Clinicians' and patients' experiences, expectations and priorities about OC management may differ.
authors: Sussex Health Outcomes Research and Education in Cancer (SHORE-C), Brighton and Sussex Medical School, University of Sussex, Falmer, Brighton BN1 9QG, UK. val@sussex.ac.uk
authors: V
authors: V
authors: Jenkins
authors: S
authors: S
authors: Catt
authors: S
authors: S
authors: Banerjee
authors: C
authors: C
authors: Gourley
authors: A
authors: A
authors: Montes
authors: I
authors: I
authors: Solis-Trapala
authors: K
authors: K
authors: Monson
authors: L
authors: L
authors: Fallowfield
mesh_terms: D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008495:Medical Oncology / Q000706:statistics & numerical data; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000628:therapy*; D010342:Patient Acceptance of Health Care; D010818:Practice Patterns, Physicians'; D011788:Quality of Life; D011795:Surveys and Questionnaires; D015996:Survival Rate; D006113:United Kingdom
references: Cancer. 2008 Dec 15;113(12):3459-66
references: 18988231
references: J Natl Cancer Inst. 1993 Mar 3;85(5):365-76
references: 8433390
references: Lancet Oncol. 2013 Mar;14(3):183-5
references: 23333118
references: J Clin Oncol. 2011 Mar 10;29(8):954-6
references: 21282536
references: N Engl J Med. 2011 Dec 29;365(26):2473-83
references: 22204724
references: N Engl J Med. 2011 Dec 29;365(26):2484-96
references: 22204725
references: Lancet. 2011 Jan 8;377(9760):127-38
references: 21183212
references: Nat Rev Clin Oncol. 2011 Oct 18;9(1):41-7
references: 22009075
references: J Clin Oncol. 2012 Aug 10;30(23):2885-90
references: 22802321
references: Gynecol Oncol. 1996 Sep;62(3):329-35
references: 8812525
references: Cancer Nurs. 2006 May-Jun;29(3):176-87
references: 16783116
references: Eur J Cancer. 2010 Oct;46(15):2726-38
references: 20674333
references: Eur J Oncol Nurs. 2008 Dec;12(5):412-7
references: 18845479
references: Lancet Oncol. 2013 Mar;14(3):236-43
references: 23333117
references: Gynecol Oncol. 2002 Aug;86(2):200-11
references: 12144829
references: Gynecol Oncol. 2009 Feb;112(2):422-36
references: 18990435
references: Eur J Cancer. 2003 Jul;39(10):1402-8
references: 12826043