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 (≤6 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.
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 (≤6 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.
Authors: Virginia Sun; Christopher S Wendel; Wendy Demark-Wahnefried; Marcia Grant; Carmit K McMullen; Joanna E Bulkley; Lisa J Herrinton; Mark C Hornbrook; Robert S Krouse Journal: Nutr Cancer Date: 2018-12-20 Impact factor: 2.900
Authors: Virginia Sun; Marcia Grant; Christopher S Wendel; Carmit K McMullen; Joanna E Bulkley; Andrea Altschuler; Michelle Ramirez; Carol M Baldwin; Lisa J Herrinton; Mark C Hornbrook; Robert S Krouse Journal: Ann Surg Oncol Date: 2015-07-10 Impact factor: 5.344
Authors: Mubarika Alavi; Christopher S Wendel; Robert S Krouse; Larissa Temple; Mark C Hornbrook; Joanna E Bulkley; Carmit K McMullen; Marcia Grant; Lisa J Herrinton Journal: Ann Surg Oncol Date: 2017-08-07 Impact factor: 5.344
Authors: Helena C Frawley; Kuan-Yin Lin; Catherine L Granger; Rosemary Higgins; Michael Butler; Linda Denehy Journal: Support Care Cancer Date: 2019-06-27 Impact factor: 3.603
Authors: Lisa J Herrinton; Andrea Altschuler; Carmit K McMullen; Joanna E Bulkley; Mark C Hornbrook; Virginia Sun; Christopher S Wendel; Marcia Grant; Carol M Baldwin; Wendy Demark-Wahnefried; Larissa K F Temple; Robert S Krouse Journal: CA Cancer J Clin Date: 2016-03-21 Impact factor: 508.702
Authors: Catherine Benedict; Vivian M Rodriguez; Jeanne Carter; Larissa Temple; Christian Nelson; Katherine DuHamel Journal: Support Care Cancer Date: 2015-10-07 Impact factor: 3.603