The Supportive Management of Depression and Anxiety in Ovarian Cancer Patients Experiencing a Recurrence: A Qualitative Study

Problem

Ovarian cancer (OvCa) is the fifth most common female cancer in the UK and incidence is rising. Crucially, over 70% of women diagnosed with OvCa experience disease recurrence. Cancer patients who experience recurrence have significant psychological co-morbidity. Current guidelines recommend that the management of psychological distress forms a key component of improved cancer survivorship in the UK. There is at present a paucity of data assessing the primary causes of psychological distress in women with recurrent OvCa and how best to manage this distress via interventional support. The aim of this study was to address these issues.

Approach

To address this issue semi-structured interviews were conducted with 20 women with recurrent OvCa. Inclusion required the patients to have experienced at least one recurrence. The interviews were transcribed and analysed using thematic analysis.

Findings

Three overarching themes emerged: 1) route to diagnosis and recurrence, 2) psychological impact of recurrence and 3) specific supportive care requirements. Key findings showed that recurrent OvCa patients experience a high level of psychological distress and additional support is required. Many of the women held positive attitudes and displayed a desire for this to be translated in any subsequent support intervention. There were clear views that specific group and internet support were the ideal mechanisms for supportive interventions. Several important issues relating to logistics and content were raised.

Consequences

Our preliminary data supports the view that women with recurrent OvCa experience a high level of psychological distress and that specific supportive care interventions are needed to allow these individuals to better manage their distress. We aim to use the findings from this study to inform the design and development of a OvCa specific support intervention that will allow these patients to proactively manage their psychological distress and thus improve their survivorship and quality of life.