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. 2016 Apr;10(2):261-70.
doi: 10.1007/s11764-015-0472-9. Epub 2015 Aug 6.

Survivors of gynecologic malignancies: impact of treatment on health and well-being

Shannon N Westin  1 , Charlotte C Sun  2 , Celestine S Tung  3 , Robin A Lacour  4 , Larissa A Meyer  2 , Diana L Urbauer  5 , Michael M Frumovitz  2 , Karen H Lu  2 , Diane C Bodurka  2
Affiliations

Survivors of gynecologic malignancies: impact of treatment on health and well-being

Shannon N Westin et al. J Cancer Surviv. 2016 Apr.

Abstract

Purpose: While overall survival from gynecologic malignancies has greatly improved over the last three decades, required treatments can lead to multiple health issues for survivors. Our objective was to identify health concerns that gynecologic cancer survivors face.

Methods: A systematic, stratified sample of women with gynecologic malignancies was surveyed for 18 health issues occurring before, during, or after treatment. The impact of clinical features and treatment modality on health issues was assessed through multivariate logistic regression models.

Results: Of 2,546 surveys mailed, 622 were not received by eligible subjects secondary to invalid address, incorrect diagnosis, or death. Thus, 1924 survivors potentially received surveys. Of the 1,029 surveys (53.5%) completed, median age was 59 years; diagnoses included 29% cervical, 26% endometrial, 26% ovarian/primary peritoneal/fallopian tube, 12.1% vulvar, and 5.4% vaginal cancers. The most frequently reported health issues included fatigue (60.6%), sleep disturbance (54.9%), urinary difficulties (50.9%), sexual dysfunction (48.4%), neurologic issues (45.4%), bowel complaints (42.0%), depression (41.3%), and memory problems (41.2%). These rankings were consistent with patients' self-reported rankings of "highest impact" personal issues. After controlling for demographic and clinical variables, multivariate analyses revealed that treatment modality impacted the odds of experiencing a given health issue.

Conclusions: Our study demonstrates that gynecologic cancer survivors experience a high frequency of health conditions and highlights the association between treatment modality and specific health concerns.

Implications for cancer survivors: The study findings highlight the multiple health concerns experienced by gynecologic cancer survivors and suggest the potential for developing interventions to mitigate these concerns in survivorship.

Keywords: Gynecologic malignancy; Health issues; Quality of life; Survivorship; Treatment.

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Conflict of interest statement

Conflict of Interest: The authors declare that they have no conflict of interest.

Figures

Figure 1
Figure 1. Sample item from questionnaire
The questionnaire explored a wide range of health issues in gynecologic cancer survivors. This item demonstrates description of specific memory issues experienced by the patient as well as clarification of timing of onset of these issues.
Figure 2
Figure 2. Flow chart outlining gynecologic cancer survivor participation and inclusion
Surveys were sent to 2,546 gynecologic cancer survivors. Of those, 1,924 surveys were received by subjects who met the inclusion criteria. The total number of responses was 1,239 (64.4%). One hundred sixty-six declined to complete the survey and 44 were unable to complete the survey secondary to inability to read and/or write English. Thus, 1,029 valid completed questionnaires (53.5%) were available for analysis. GYN CA; Gynecologic cancer
See this image and copyright information in PMC

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