Health-Related Quality of Life Assessment in Patients With Rectal Cancer Treated With Curative Intent

Abstract

-Background -The treatment of median and distal rectal cancer has evolved a lot in the last decades due to the dissemination of the technique of total mesortal excision and the use of neoadjuvant chemotherapy and radiotherapy. However, this multidisciplinary approach can affect patients' quality of life in a number of ways that deserve to be adequately assessed. Objective -To evaluate immediate and late health related quality of life in patients with rectal cancer treated with curative intent. Methods -Prospective study including patients with non-metastatic mid or low rectal cancer. EORTC QLQ-C30 and EORTC-CR38 questionnaires were applied before, 3 months and 12 months after treatment. The mean scores of the questionnaires were stratified into 4 categories for the purpose of comparing the results at different moments. Results -Twenty nine patients completed the 1st and 2nd questionnaires and 12 completed the three questionaries. Patient´s mean age was 50.8 years and 62% were female. Sphincter preservation was possible in 89.6%. Overall health scores and quality of life improved after three months after 12 months. After three months, sexual satisfaction, female sexual problems and future perspective were worsen, but gastrointestinal symptoms, sphincter problems, and weight loss were improved. After 12 months the Future Perspective deteriorated, but there was improvement of the problems related to stoma, sphincter problems and body image. Conclusion -Despite the complexity of the treatment of rectal cancer within a specialized service, quality of life was preserved and was satisfactory in most of the studied aspects. HEADINGS -Quality of life. Rectal neoplasms. Health related quality of life. Colorectal neoplasms.

Assessment of Quality of Life Following Radiotherapy in Patients with Rectum Cancer

“…Although there was deterioration in embarrassment and body image scores in patients with stoma in studies [18], we did not observe a difference due to the very low number of patients with stoma.…”

Body Image Issues in Patients With Colorectal Cancer

“…Studies in this review revealed that patients reported better body image over time 29,30,52,56,57,59,64,65 . However, patients with a stoma tended to report body image distress consistently over time and even worsening of distress 22,24,31,33,47,49,71 …”

“…The time frame for assessing body image ranged from 1 to 2 weeks after surgery 19 to 10 years 68 after completed treatment. Almost all studies assessed body image for CRC after surgery; only 7 studies measured body image before surgery 22,41,47,49,60,64,65 …”

“…Studies in this review revealed that patients reported better body image over time. 29,30,52,56,57,59,64,65 However, patients with a stoma tended to report body image distress consistently over time and even worsening of distress. 22,24,31,33,47,49,71 ADJUVANT THERAPY Patients who underwent adjuvant chemotherapy after surgery reported worse body image than patients who did not at 1-and 2year follow-ups.…”

“…Almost all studies assessed body image for CRC after surgery; only 7 studies measured body image before surgery. 22,41,47,49,60,64,65 Prevalence of Body Image Distress…”