Description:

GOG-0249 Quality of Life (QOL) Form Pelvic Radiation Therapy or Vaginal Implant Radiation Therapy, Paclitaxel, and Carboplatin in Treating Patients With High-Risk Stage I or Stage II Endometrial Cancer Endometrial Cancer NCT00807768 Quality of Life - GOG-0249 Quality of Life (QOL) Form - 2786253v1.0

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  1. 9/19/12
  2. 7/14/17
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July 14, 2017

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Creative Commons BY-NC 3.0
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Endometrial Cancer Radiation Therapy NCT00807768 GOG-0249

Below is a list of statements that other people with your illness have said are important. By circling one (1) number per line, please indicate how true each statement has been for you during the past 7 days

PHYSICAL WELLBEING
I have a lack of energy
I have nausea
Because of my physical condition, I have trouble meeting the needs of my family
I have pain
I am bothered by side effects of treatment
I feel ill
I am forced to spend time in bed
FUNCTIONAL WELLBEING
I am able to work (include work at home)
My work (include work at home) is fulfilling
I am able to enjoy life
I have accepted my illness
I am sleeping well
I am enjoying the things I usually do for fun
I am content with the quality of my life right now
Additional Concerns
I have swelling in my stomach area
I have cramps in my stomach area
I have discomfort or pain in my stomach area
I have vaginal bleeding or spotting
I have vaginal discharge
I am unhappy about a change in my appearance
I have hot flashes
I have cold sweats
I have night sweats
I feel fatigued
I have pain or discomfort with intercourse
I have trouble digesting food
I have been short of breath
I am bothered by constipation
I urinate more frequently than usual
I have discomfort or pain in my pelvic area
My vagina feels too narrow or short
I have control of my bowels
I have diarrhea
Ntx4 Subscale
I have numbness or tingling in my hands
I have numbness or tingling in my feet
I feel discomfort in my hands
I feel discomfort in my feet
FACIT-Fatigue Subscale
I feel fatigued
I feel weak all over
I feel listless ("washed out")
How often did you feel tired
I have trouble starting things because I am tired
I have trouble finishing things because I am tired
I have energy
I am able to do my usual activities
I need to sleep during the day
I am too tired to eat
I need help doing my usual activities
I am frustrated by being too tired to do the things I want to do
I have to limit my social activity because I am tired
Promis Fatigue Short Form 1
How often did you feel tired
How often did you experience extreme exhaustion
How often did you run out of energy
How often did your fatigue limit you at work (include work at home)
How often were you too tired to think clearly
How often were you too tired to take a bath or shower
How often did you have enough energy to exercise strenuously
To Be Completed By Clinical Staff
Status of the QOL assessment

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