Aim of the ovarian cancer case study
This case study aims to facilitate the development of competencies that reflect the role of the Specialist Cancer Nurse (SCN) in preventing, assessing and managing disease and treatment-related care for people affected by ovarian cancer across the cancer journey.
One in 81 women are diagnosed with ovarian cancer before the age of 85,7 but the impact on society is far greater than this figure implies.
Women diagnosed with ovarian cancer often have a poor prognosis because, in more than 70% of women, the disease is usually diagnosed at an advanced stage.8
There are many points along the cancer journey when the SCN can improve outcomes for people at risk or affected by ovarian cancer. These include:
Section 1: Find the condition early
- Ovarian cancer has mistakenly been called the 'silent killer',9, 10 because the disease is often not detected until it is at an advanced stage. However, the majority of women do experience symptoms before diagnosis.9
- Women who do not seek medical attention for their symptoms are significantly more likely to be diagnosed with advanced stage disease. Such delays in diagnosis result in loss of opportunity to attain a survival rate of about 78% for women diagnosed with early stage ovarian cancer.3
- As the consequences of late stage diagnosis are significant, women and SCNs need to know the symptoms associated with ovarian cancer in order to facilitate appropriate and timely health-seeking behaviours and referral.
Section 2: Have the best treatment and support during active treatment
- Treatment of ovarian cancer is intense and usually involves extensive surgery and antineoplastic agents.
Section 3: Have the best treatment and support between and after active treatment
- While 70 to 80% of women diagnosed with advanced epithelial ovarian cancer will initially respond to antineoplastic therapies, more than 60% of these women will experience a disease recurrence.11
- Advanced surgical techniques and more effective, less toxic regimens have steadily increased the survival rate for women with ovarian cancer.
- Despite an increase in longevity, women living with ovarian cancer face unpleasant symptoms and major compromises in quality of life, including fatigue, altered bowel and bladder function, gastrointestinal disturbances, pain, peripheral neuropathy and sexual dysfunction. These conditions often require intervention from an SCN.
Section 4: Have the best care at the end of life
- Once a woman relapses, there is generally no prospect of cure.12 Aims of treatment shift to disease control, symptom palliation, and prolongation of life.
- Women with ovarian cancer have a high symptom burden compared with those living with other cancers.3 Palliative care services may be beneficial at this stage.
- Although specialist palliative care professionals may be required only intermittently in the early phases of disease, the need may become more intense as the disease progresses.5
- Particular challenges in the care of women with advanced ovarian cancer are recurrent accumulation of ascites, bowel obstruction, pleural effusions and malnutrition.14 Women facing these challenges need monitoring and support from specialist services.