Lived experiences of women with recurring ovarian cancer

Abstract

Background

Women with recurring ovarian cancer are living longer, due to advances in treatment options. They are now often outpatients, experiencing rapid encounters on treatment days. Whether this shift in care meets women's needs has been scarcely explored scientifically.

Purpose of the study

This study aimed to illuminate the phenomenon of living with recurring ovarian cancer as experienced by women in that condition.

Methods and sample

A descriptive phenomenological method was used. Eight open-ended interviews with four women were performed approximately three and five years after the first recurrence of ovarian cancer. During these years the women had repeated clinically and radiologically verified recurrence requiring chemotherapy.

Key results

The phenomenon of living with recurring ovarian cancer meant that the women felt forced to pay attention to the failing body in order to avoid a potential breakdown. The growing limitation of their intermittent strength meant that strength had to be captured and protected. Sharing their lives with others was difficult, due to the different living conditions. The women found no space to mediate their experiences, either in close relationships or with health care professionals. But, the circumstances they lived under also generated a gratitude for the unexpected extra time.

Conclusions

The findings revealed that the four women were grateful to live a while longer, but needed to share their state of being. The findings are indeed directed to health care professionals, who need to provide a more patient-centred care to meet the women's needs.

Introduction

Ovarian cancer and its consequences for the women are described as not getting enough attention from the general population and the medical settings, as well as being inadequately studied by the research community (Power et al., 2008), although the diagnosis has a significant impact on women's lives throughout the disease trajectory (Howell et al., 2003). Women who suffer a recurrence of ovarian cancer are today able to continue treatment, due to the many advances in chemotherapy options and antiemetics (Jelovac and Armstrong, 2011). This implies that women live with the disease for longer than ever before (Herzog and Pothuri, 2006). Lockwood-Rayermann (2006) stated that the former palliative care of patients with advanced ovarian cancer, who was expected to live a short time, has now been replaced by outpatient chemotherapy spanning years. This change is in accordance with experiences from clinical practice. The increased outpatient care and improved time of survival is a challenge for health care providers (Martin, 2002), and it is unclear whether this shift responds to the patients' needs. Prior studies regarding this issue found that the length of the treatment, and number of chemotherapy cycles, are significant factors when it comes to daily living (Tabano et al., 2002), because repeated cycles have a cumulative toxic effect (Almadrones, 2003) that burdens patients both temporarily and permanently (Sun et al., 2007). Women receiving aggressive cancer treatments are described as being at risk for developing psychiatric morbidity (McCorkle et al., 2003). However, there is still a gap in knowledge regarding how women describe their world when living with recurring ovarian cancer from a life-world perspective. There is a need to highlight this area. The aim of this study was to illuminate the phenomenon of living with recurring ovarian cancer as lived and experienced by women in that condition.