Dietary Practices After Primary Treatment for Ovarian Cancer: A Qualitative Analysis From the OPAL Study

Background Little is known about the dietary practices of women who have completed primary treatment for ovarian cancer, many of whom will go on to have cancer recurrence and further treatment. Knowledge of dietary practices is needed to optimize care. Objective Our aim was to identify dietary practices after primary treatment for ovarian cancer and evaluate how these practices differ by disease recurrence and treatment status. Design Women with invasive epithelial ovarian cancer were provided with the following open-ended question after completing a food frequency questionnaire: “Is there anything we haven’t asked you about your diet in the last 1 to 2 months that you feel is important?” Participants/setting Participants were from the OPAL (Ovarian Cancer Prognosis and Lifestyle) Study in Australia. Main outcomes The main outcomes were dietary practices after primary treatment for ovarian cancer and factors affecting these practices. Analysis Participants’ responses were analyzed using content analysis. Individual content codes were categorized and reported by recurrence and treatment status at questionnaire completion. Results Two hundred eighty-six women provided responses on 363 questionnaires. Those undergoing further treatment for recurrence commonly reported dietary regimens with clinical indications (eg, low fiber to avoid bowel obstructions, high energy/protein to minimize nutritional deficits). Those not undergoing further treatment frequently reported “popular” diets (eg, organic, plant-based, and alkaline). For women with cancer recurrence, dietary practices were affected by poor appetite and late effects of treatment. For women without recurrence, other comorbidities, geographical location, family, and friends appeared to influence dietary practices. In both groups, nutrition information sources and personal beliefs informed dietary practices. Participant responses that referenced media or online sources often included misinformation. Conclusions After primary treatment for ovarian cancer, women report dietary practices that may not be captured in standard food frequency questionnaires. Dietary practices and factors affecting these practices likely differ by treatment and recurrence status. Improved access to evidence-based dietary information and support is needed.