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Optimism, Distress, Health-Related Quality of Life, and Change in Cancer Antigen 125 Among Patients With Ovarian Cancer Undergoing Chemotherapy

From the Dana Farber Cancer Institute and Harvard School of Public Health, Boston, Massachusetts (J.S.d.M.); Children's Hospital Boston and Harvard Medical School, Boston, Massachusetts (C.A.d.M.); The University of Texas M. D. Anderson Cancer Center, Houston, Texas (K.B.-E., M.W.B., L.C.); and Regional Medical and Research Specialists, Pfizer Oncology, New York, New York (A.K.).

Address correspondence and reprint requests to Janet S. de Moor, MPH, PhD, Dana Farber Cancer Institute, Center for Community Based Research, 44 Binney Street, Smith 342, Boston, MA 02115. E-mail: janet_demoor{at}dfci.harvard.edu

Objective: This study investigated whether situational and dispositional optimism were protective against dimensions of distress and aspects of health-related quality of life (HQoL) in patients with ovarian cancer undergoing chemotherapy. This study also evaluated whether optimism predicted a decrease in cancer antigen (CA) 125 levels during treatment.

Methods: Ninety women with epithelial ovarian cancer were assessed at the start and end of chemotherapy. Optimism, distress, and HQoL were measured by self-report; CA 125 levels were gathered from patients' medical charts.

Results: Both measures of optimism were inversely associated with baseline anxiety, perceived stress, and depression. In addition, situational optimism was positively associated with baseline social and physical well-being, and dispositional optimism was positively associated with baseline social and functional well-being. However, neither measure of optimism predicted domains of distress or HQoL at the follow-up assessment after controlling for baseline levels. Dispositional optimism predicted CA 125 at the end of treatment after controlling for baseline levels. However, neither situational nor dispositional optimism predicted CA 125 falling to normal levels (35 U/mL).

Conclusion: Consistent with prior research, optimism was inversely associated with distress and positively associated with HQoL in patients with ovarian cancer undergoing chemotherapy. Higher levels of dispositional optimism at the start of chemotherapy were associated with a greater decline in patients' CA 125 during treatment.

Key Words: optimism • anxiety • depression • perceived stress • health-related quality of life • CA 125

Abbreviations: CA = cancer antigen; HQoL = health-related quality of life; NK = natural killer; VEGF = vascular endothelial growth factor; PSS = Perceived Stress Scale; CES-D = Center for Epidemiologic Studies Depression Scale; FACT-O = Functional Assessment of Cancer Therapy-Ovarian; LOT-R = Life Orientation Test-Revised; TSOS = Treatment-Specific Optimism Scale; SES = socioeconomic status; SWB = social well-being; PWB = physical well-being; FWB = functional well-being; = change; SD = standard deviation; SE = standard error; = sample mean.

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