- 作者：Gillian Knowles ; Rachel Haigh ; Catriona McLean ; Hamish A. Phillips ; Malcolm G. Dunlop ; Farhat V.N. Din
- 关键词：Rectal cancer ; Surgery ; Radiotherapy ; Late effects ; Quality of life ; Cancer survivors
- 刊名：European Journal of Oncology Nursing
- 出版年：2013
- 出版时间：October, 2013
- 年：2013
- 卷：17
- 期：5
- 页码：570-577
- 全文大小：225 K
Purpose
Survival from rectal cancer has improved substantially. Understanding the consequences of?treatment is important to optimise patient support and minimise impact on daily life. We aimed to?define the long-term prevalence of pelvic dysfunction following curative rectal cancer surgery (+/??radiotherapy) within the context of overall quality of life.Methods
We evaluated bowel, urinary and sexual function and quality of life using three validated questionnaires in patients treated for rectal cancer. This group was compared to patients undergoing abdominal surgery without pelvic dissection for colon cancer during the same time period.
Results
The response rate was 57 % (381/667) with a median time interval of 4.4 years. A subset of rectal patients documented persistent problems with faecal leakage (16 % ); requiring to alter daily activities (18 % ); always needing to wear a protective pad (17 % ); rarely or never emptying their bowels fully (31 % ); difficulty controlling the passage of gas (32 % ) and requiring to modify diet (30 % ). Altered bowel function was found to impact on overall quality of life. Men reported increased erectile function difficulties. Pre-operative radiotherapy was associated with increased defecation problems as was low level of anastomosis (¡Ü6?cm).
Conclusion
In keeping with emergent evidence, this study has quantified the extent of late adverse effects with a sub-set of rectal cancer patients reporting persistent bowel function problems. The implications are now to consider current follow-up services and to ¡®trial¡¯ new models of comprehensive assessment and interventions in patients who are ¡®at risk¡¯ of experiencing late adverse effects of treatment.