Care and mobility considerations

Stage 1 and 2 disease

Long term side effects of treatment are infertility and early menopause. There are unlikely to be any long term care and mobility needs after treatment. The exception to this is the enduring but rare side effects of chemotherapy. Needs are likely to arise when disease recurs.

Stage 3 disease

Long term side effects of treatment are infertility and early menopause. There are no long term disabling effects other than the rare enduring side effects of chemotherapy. Recurrent disease is common and may occur only a few months after treatment of initial disease – up to date medical evidence from the treating hospital will be important.

Stage 4 disease

Survival for two years after diagnosis with this stage of disease is a good outcome. Most of these people are terminally ill. Those that are fit enough to have surgery are likely to go on to have chemotherapy. A proportion may have many of the problems of the recurrent disease group described above.

Problems specific to ovarian cancer include:

• Pelvic pain syndromes
• Problems with the bowel or bladder, these may affect continence of either and occasionally the formation of a stoma such as a colostomy or ileostomy if the lower bowel or rectum is affected by the cancer may be necessary

Metastatic and recurrent disease

The aim of treatment is to remove the cancer and try to get that person into remission usually with chemotherapy. Remission may last for a variable length of time. During remission a woman would be expected to be well with no disabling effects. Once disease has returned and remission has ended it is a case of controlling the disease for as long as possible. Further chemotherapy and/or surgery or radiotherapy may induce a second shorter remission but it will not cure it. For some women 4 – 6 lines of treatment may be given in this way over a number of years.

There may be disabling effects from metastatic disease anywhere in the body including:

• Liver metastases – these may cause pain, fatigue and in the later stages, mental confusion, abdominal swelling or pain and jaundice
• Abdominal bloating /distension due to fluid accumulation (ascites)
• Nausea /vomiting/ sub acute bowel obstruction due to peritoneal metastases – this may result in recurrent hospital admission in advanced disease
• Lung metastases or malignant pleural effusion – may cause very disabling breathlessness reducing mobility to a few yards.
• Brain metastases – these may cause fits, personality change, confusion, difficulties with balance, walking and self care
• Bone metastases – pain and pathological fractures (rare)

Click on the link for details of:

• Side effects of Chemotherapy
• Palmar Plantar Syndrome
• Radiotherapy & Brachytherapy
• Psychological effects

Amended April 2008