A literature review of post‐treatment survivorship interventions for colorectal cancer survivors and/or their caregivers

Abstract

Objective Colorectal cancer (CRC) survivors have reported a number of concerns and unmet needs after treatment completion. This paper aims to explore existing survivorship interventions after CRC treatment according to the American Cancer Society CRC Survivorship Care Guidelines, to identify study gaps, and provide valuable evidence directing future research. Methods Five electronic databases, including CINAHL, PsycINFO, Embase, PubMed, and Cochrane Library databases from 2005 to October 2020, were systematically searched to identify English or Chinese literature on CRC post‐treatment survivorship interventions. Manual searching through the articles' references lists was also conducted. Results Thirty studies met the criteria, and focused on addressing issues in four CRC Survivorship Care Guidelines domains. Several issues for CRC surveillance programmes remain to be explored. Regarding the long‐term physical and psychosocial effects of CRC treatment, we found mounting evidence for various interventions to solve ostomy issues and improve distress/depression/anxiety, strong evidence for exercise to improve fatigue, and limited evidence in addressing CRC patient sexual concerns. For health promotion, high‐quality evidence was found for exercises to improve cardiopulmonary fitness, metabolism, tumour‐related biomarkers, and short‐term improvement in physical fitness and QOL. Emerging evidence was found for a survivorship care plan to improve patient perceptions of care coordination. Conclusions Further refinements based on the existing evidence, and the development of comprehensive CRC survivorship care comprising multiple essential survivorship components, are required. Furthermore, considering both survivor and caregiver cancer survivorship needs, future research may optimise the care delivered, and help survivors and their families live better with cancer.

Health-Related Quality of Life in Metastatic Colorectal Cancer Patients Treated with Curative Resection and/or Local Ablative Therapy or Systemic Therapy in the Finnish RAXO-Study

“…The need for survivorship programmes is recognized. Cognitive therapy is less studied but evidence supports psychoeducation, psychosocial support, and nurse-led supportive care [ 57 ], to relieve anxiety and depression, and exercise interventions for fatigue and cardiopulmonary fitness. Unfortunately, there is limited evidence for interventions to address sexual concerns [ 57 ].…”

Patients´ experiences in a newly established clinic for late complications after colorectal and anal cancer treatment: a qualitative study

“…All patients were included after informed consent. Information about the interview was given either by telephone or by electronic communication to the patient's personal secure electronic mailbox [10]. All patients were informed about anonymity and con dentiality, and it was underlined that participation was voluntary and that they could withdraw from the study with no consequence for their future treatment in the clinic.…”

“…All patients in our department undergoing surgery for colorectal and anal cancer after October 2019 were invited to attend our late complication clinic three months after surgery. The patients were invited digitally through patients´ personal secure electronic mailbox [10]. They were asked to ll out Patient Reported Outcome Measures (PROMs) concerning various symptoms of late complications, and if they wanted, they could indicate whether they wished to be contacted by the clinic by phone.…”

Establishment of a nurse-led clinic for late complications after colorectal and anal cancer surgery: a descriptive study

“…More patients survive for a longer time after diagnosis and thereby more patients are living with cancer as cancer survivors [ 4 , 5 ]. However, there is growing evidence of risk for late complications after surgical and oncological treatment of the diseases [ 6 – 9 ]. Thus, late complications and symptoms after treatment for colorectal and anal cancers are common and they include bowel symptoms [ 10 – 13 ], urinary problems [ 14 – 17 ], sexual dysfunction [ 8 , 18 ], depressive symptoms [ 19 , 20 ], fatigue [ 21 , 22 ], sleep problems and alterations in social and physical activities [ 23 , 24 ], chronic pain [ 25 ], nutritional issues, and resulting late return to work [ 26 ].…”

“…Identification of late complications and relevant treatment options are either not available or are not implemented or standardized in health care [ 8 , 9 ]. Therefore, we set up a multidisciplinary clinic treating patients with a need for survivorship-treatment after colorectal and anal cancer surgery, and patients were invited to the clinic after screening for late complications.…”