Survivorship Care For Women Living With Ovarian Cancer: Protocol For a Randomized Controlled Trial

BACKGROUND: Ovarian cancer ranks 12th in cancer incidence among women in the United States and 5th among causes of cancer-related death. The typical treatment of ovarian cancer focuses on disease management, with little attention given to the survivorship needs of the patient. Qualitative work alludes to a gap in survivorship care; yet, evidence is lacking to support the delivery of survivorship care for individuals living with ovarian cancer. We developed the POSTCare survivorship platform with input from survivors of ovarian cancer and care partners as a means of delivering patient-centered survivorship care. This process is framed by the chronic care model and relevant behavioral theory. OBJECTIVE: The overall goal of this study is to test processes of care that support quality of life (QOL) in survivorship. The specific aims are threefold: first, to test the efficacy of the POSTCare platform in supporting QOL, reducing depressive symptom burden, and reducing recurrence worry. In our second aim, we will examine factors that mediate the effect of the intervention. Our final aim focuses on understanding aspects of care platform design and delivery that may affect the potential for dissemination. METHODS: We will enroll 120 survivors of ovarian cancer in a randomized controlled trial and collect data at 12 and 24 weeks. Each participant will be randomized to either the POSTCare platform or the standard of care process for survivorship. Our population will be derived from 3 clinics in Texas; each participant will have received some combination of treatment modalities; continued maintenance therapy is not exclusionary. RESULTS: We will examine the impact of the POSTCare-O platform on QOL at 12 weeks after intervention as the primary end point. We will look at secondary outcomes, including depressive symptom burden, recurrence anxiety, and physical symptom burden. We will identify mediators important to the impact of the intervention to inform revisions of the intervention for subsequent studies. Data collection was initiated in November 2023 and will continue for approximately 2 years. We expect results from this study to be published in early 2026. CONCLUSIONS: This study will contribute to the body of survivorship science by testing a flexible platform for survivorship care delivery adapted for the specific survivorship needs of patients with ovarian cancer. The completion of this project will contribute to the growing body of science to guide survivorship care for persons living with cancer. TRIAL REGISTRATION: ClinicalTrials.gov NCT05752448; https://clinicaltrials.gov/study/NCT05752448. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/48069

Life interrupted: the adolescent's experience when a parent has advanced cancer

It is estimated that close to 55, 000 children may experience the death of a parent from cancer each year in the United States. Families with children facing the death of a parent from cancer are a potentially vulnerable population often overlooked by health care professionals (HCP), and understudied by researchers. Little is currently know about how having a parent with advanced cancer affects children and adolescents. These youth experience many losses when a parent is diagnosed with advanced cancer, the loss of a healthy parent, the loss of both parent’s emotional and physical availability, and the loss of normalcy in their family lives. Research suggests that adolescents have been the most negatively affected group when faced with a parent’s illness. This dissertation will provide a comprehensive examination of the effects of advanced parental cancer on adolescents. A theoretical model will be presented as a guiding framework. This model is based on a prior systematic review of literature involving factors influencing children and adolescent’s adjustment to parental cancer. The first article is a systematic review of the current state of empirical literature on the impact of a parent’s advanced cancer on children and adolescents. Article 2 offers an inductive content analysis of 7 in depth qualitative interviews with adolescent’s living with a parent diagnosed with advanced cancer. The core construct that organized study results was weaving cancer into our lives. Our findings shed light on how families managed when the “terminal phase” of cancer stretched on for many years. Implications for HCP’s include the need to facilitate family interventions that provide parents and adolescents with a venue to communicate and process the impact of cancer on their lives. Article three utilized a hermeneutic phenomenological approach to discover the lived experience of adolescent’s facing advanced parental cancer. Four essential themes emerged from the analysis: Life interrupted, Being there, Managing emotions, Positives prevail. The findings in this study underscore the significant impact an advanced cancer diagnosis can make on a family system and suggest that the experience may also have the potential of creating opportunities for growth and well being. These findings indicate that some adolescents are able to find meaning in these difficult circumstances which helps shape their growing identity. The themes of positive growth and gratitude that emerged from this dissertation suggest that this is a potentially powerful protective factor that adolescents use to maintain positive adjustment during a parent’s protracted illness. Researchers and HCP’s can build on these findings to closely examine the potential for gratitude as a construct in intervention programs for families facing parental cancer.Social Wor