Patient Perspectives on Consequences of Resectable Colorectal Cancer Treatment: a Qualitative Study

Abstract

Background: Colorectal cancer is diagnosed in approximately 500,000 patients each year in Europe, leading to a high number of patients having to cope with the consequences of resectable colorectal cancer treatment. As treatment options tend to grow, more information on these treatments’ effects is needed to properly engage in shared decision-making. This study aims to explore the impact of resectable colorectal cancer treatment on patients’ daily life. Methods: Patients (≥18 years) who underwent an oncological colorectal resection between 2018 and 2021 were selected. Purposeful sampling was used to include patients who differ in age, comorbidity, (neo-)adjuvant therapy, postoperative complications and stoma presence. Semi-structured interviews were conducted, guided by a topic guide. Interviews were fully transcribed and subsequently thematically analyzed using the framework approach. Analyses were done by using the predefined themes: 1) daily life and activities, 2) psychological functioning, 3) social functioning, 4) sexual functioning and 5) healthcare experiences. Results: Sixteen patients with a follow-up between 0.6 and 4.4 years after surgery were included in this study. Participants reported several challenges they experience due to poor bowel functioning, stoma presence, chemotherapy-induced neuropathy, fear of recurrence and sexual dysfunction, however, they were reported not to interfere much with daily life. Conclusion: Colorectal cancer treatment leads to several challenges and treatment-related health deficits. This is often not recognized by generic patient-reported outcome measures, but the findings on treatment-related health deficits presented in this study, contain valuable insights which might contribute to improving colorectal cancer care, shared decision making and value based healthcare.