Nurse-Led Telehealth Program Eases the Hidden Burden of Ovarian Cancer

Ovarian cancer is often described as a silent disease, and for good reason. With no reliable early detection test, roughly three-quarters of cases in Australia are diagnosed at an advanced stage, when intensive treatment is required and side effects are severe. Even after treatment, most patients experience recurrence within two years, and the five-year survival rate remains below fifty percent. Yet a new national evaluation suggests that one of the most powerful interventions for these patients may not come from a new drug or surgical technique, but from a phone call with a specialist nurse who has the time to listen. A study published in Supportive Care in Cancer has found that a nationwide, nurse-led telehealth program in Australia measurably improved wellbeing and satisfaction with care among women living with ovarian cancer, while revealing the staggering scale of unmet needs this population carries.

The program, known as the Teal Support Program, was established in 2019 by Ovarian Cancer Australia, an independent national not-for-profit organisation. Its origins trace back to a 2017 consumer survey in which patients identified glaring gaps in support services, particularly the lack of access to specialised ovarian cancer nursing care. In response, the organisation built a telehealth case management service that connects individuals diagnosed with ovarian, fallopian tube, or primary peritoneal cancers with specialist oncology or gynaecology nurses, each with a minimum of five years of experience caring for people with these cancers. Patients can join through referrals from Ovarian Cancer Australia services, external health professionals, or by self-referral, and the service operates as an extension of each patient’s treating medical team rather than a replacement for it.

The technical architecture of the program is deceptively simple but carefully structured. Upon enrolment, every participant undergoes a comprehensive initial assessment covering cancer- and treatment-related symptoms, general and psychological health, and both immediate and long-term supportive care needs, including the needs of carers and family members. Following that assessment, nurses deliver five distinct types of support: ongoing assessment and intervention across the care continuum; information support through verbal guidance and written or digital resources; care coordination involving direct communication with the treating team; nurse-led psychosocial counselling addressing emotional, spiritual, and social needs; and crisis support for urgent, unscheduled needs. Since 2021, the program has also included in-house psychologists and counsellors to whom patients with complex psychological, mental health, or sexual health needs can be referred. Regular multidisciplinary team meetings are held to discuss complex cases, and nurses maintain direct communication with each participant’s oncology team to keep care coordinated and responsive.

To determine whether this model actually works, researchers led by Patsy Yates of Queensland University of Technology conducted an independent evaluation using the RE-AIM framework, which assesses reach, effectiveness, adoption, implementation, and maintenance. The effectiveness findings, reported in the new paper, come from an embedded mixed methods design. Between August 2020 and February 2022, 652 individuals enrolled in the program, of whom 112, or seventeen percent, consented to participate in the evaluation. Each completed validated surveys at baseline and then at three, six, and twelve months, measuring symptom burden with the Measure of Ovarian Symptoms and Treatment, psychological distress with the General Health Questionnaire, quality of life with the Functional Assessment of Cancer Therapy-Ovarian instrument, supportive care needs with the Supportive Care Needs Survey, and self-management confidence with the Cancer Survivors Self-efficacy Scale. Thirty participants were also purposively selected for semi-structured interviews, chosen to reflect diversity in age, time since diagnosis, cancer stage, treatment status, and location.

The baseline data paint a stark picture of the disease’s hidden toll. Fatigue at moderate to severe levels affected sixty-five percent of participants, anxiety fifty-six percent, and sleep disturbances fifty percent. Fewer than half reported good or very good physical, emotional, or overall wellbeing. Forty-three percent reported high psychological distress, and the most common unmet needs were psychological rather than physical: uncertainty about the future affected fifty-four percent, fear of cancer spreading forty-eight percent, and anxiety forty-two percent. Roughly a quarter of participants lacked confidence in self-managing fatigue or distress. Notably, the rates of anxiety and depression in this cohort were markedly higher than those reported in previous ovarian cancer studies, and participants experienced more severe fatigue, anxiety, and sleep problems than patients in a large international study of recurrent disease using the same assessment tool. This suggests that people who seek out the program represent a subgroup with elevated needs and a greater risk of poor outcomes than the broader patient population.

The evaluation also revealed striking demographic patterns. Participants under sixty reported significantly greater symptom burden, higher needs around sexuality and information, and poorer quality of life than older participants, likely reflecting the distinct psychological and social pressures facing younger women who are often juggling family caregiving and careers alongside treatment. Those receiving systemic treatment at the time of consent reported higher distress, more severe symptoms, poorer physical wellbeing, and lower self-management confidence than those not on active treatment. Interestingly, participants in non-metropolitan areas reported better quality of life and lower distress than city dwellers, a counterintuitive finding the researchers note in the context of a program designed to reach patients wherever they live. Service delivery data showed the program responded appropriately to need: patients with greater symptoms, higher distress, poorer quality of life, and lower self-efficacy at baseline received more services overall, and those on systemic treatment received more care coordination.

Over the twelve-month follow-up, participants showed statistically significant improvements in overall wellbeing and in satisfaction with the information they received, after adjusting for treatment status. The improvements were small in magnitude, and no significant changes were observed in ovarian cancer-specific symptoms, psychological distress, self-efficacy, or other unmet needs, a result the authors attribute partly to the nature and typical progression of the disease itself. But the qualitative findings add crucial depth to these numbers. In interviews, participants consistently valued the program in four ways: being seen and heard as a whole person, receiving trusted and personalised information and advice, experiencing meaningful emotional support, and accessing services that were flexible and timely. One woman described her hospital team as professional but transactional, checking her CA125 blood marker and wishing her luck, while her OCA nurse was, in her words, her only point of specialist support across social, emotional, practical, medical, and clinical spectrums.

The interviews also illuminated why information provision mattered so much. Participants described hospital information as generic, focused on cancer in general or on breast cancer, with little specific to ovarian cancer. The program’s nurses proactively sourced, clarified, and verified information on patients’ behalf, explaining medications, emerging treatments, clinical trial opportunities, and symptoms such as post-treatment menopause. One participant said the nurse opened up her landscape of things she did not know about; another noted that nurses could talk about research and what was in the pipeline, which she described as very important at the time. Others explained how the nurses helped them prepare for conversations with general practitioners about palliative services, giving them knowledge and confidence they would otherwise have lacked. The researchers suggest this trusted information role most likely contributed to the significant improvement in satisfaction with information over time, consistent with prior evidence linking information provision to reduced unmet needs.

Flexibility emerged as another defining strength. Participants described being able to call whenever needed, with contact frequency adapting to their circumstances, from weekly calls during low periods to monthly check-ins later on. One regional patient sent her nurse a video of a post-surgical fluid problem rather than travelling for hours during COVID-19 lockdowns. A few participants did express a preference for face-to-face support, noting that telephone contact alone was not always sufficient for their level of distress, and the authors acknowledge this limitation candidly. The evaluation also carries other caveats: it was observational rather than a controlled trial, so changes in outcomes cannot be definitively attributed to the program, and only 150 of the 652 enrolled individuals were referred for evaluation, with many non-referrals due to patients being too unwell or declining, raising the possibility of response bias.

Despite these limitations, the researchers argue the findings carry significant weight, particularly because the Teal Support Program was one of the first freely accessible, nationwide nurse-led telehealth programs for supportive cancer care, whereas comparable services in the United Kingdom were limited to hospital settings and participating sites. The program has since been embedded within the Australian Cancer Nursing and Navigation Program to support the goals of the Australian Cancer Plan, and future work will expand data capture for priority populations and integrate digital patient-reported outcome measures into clinical use. For a disease where most patients recur within two years and survival remains stubbornly low, the message of this evaluation is clear: personalised, person-centred supportive care delivered by specialist nurses over the phone can reach the patients who need it most, and deserves sustained investment as a core component of cancer care rather than an optional extra.

Subject of Research: Evaluation of a national nurse-led telehealth supportive care program for people with ovarian cancer

Article Title: Optimising ovarian cancer care: An embedded mixed methods evaluation of a national nurse-led telehealth program

Article References: Yates, P., Liu, W.-H., Ong, V., Hegarty, S., Dixon, C., Tart, A., Williams, N., & Bradhurst, B. (2026). Optimising ovarian cancer care: An embedded mixed methods evaluation of a national nurse-led telehealth program. Supportive Care in Cancer, 34(10), Article 1067. https://doi.org/10.1007/s00520-026-11284-8

Image Credits: AI Generated

DOI: 10.1007/s00520-026-11284-8

Keywords: ovarian cancer, telehealth, nurse-led care, supportive care, patient-reported outcomes, psychological distress, quality of life, case management, mixed methods, RE-AIM framework, cancer nursing, Australia