A structured questionnaire consisting of two parts was used to evaluate the impact of ovarian cancer and its management on quality of life in 28 patients with advanced disease. The first part rated their perceptions of behavioral disruption and emotional distress in five life areas, i.e., activity, daily living, health, support, and outlook as set out by the interviewer-rated Spitzer questionnaire 'Quality of Life Index of Cancer Patients.' The second part rated their response in the domain of sexual activity. Data were collected prospectively at three monthly intervals during the 2-year descriptive study. In 12 patients ovarian cancer persisted despite surgery and chemotherapy resulting in the demise of 8 women within 2 years. During the first year of study these patients described a similar deterioration in quality of life as those who had a complete response to treatment. However, after 1 year, patients with persistent disease rated their quality of life much lower. Diagnosis of persistent disease after conventional treatment proved more stressful than the diagnosis of the primary disease. Treatment of ovarian cancer will produce behavioral disruption and emotional distress, with lasting affects seen even in patients with complete response 2 years after commencing therapy. © 1993 Academic Press, Inc.