Quality of Life Outcomes in Patients with Anal Cancer after Combined Radiochemotherapy

Abstract

The global health QoL of anal cancer patients is comparable with that of the general German population, but there are specific limitations, e.g., sexual dysfunction, urological/gastrointestinal complaints, financial difficulties, fatigue, and a reduction in emotional and social well-being.

Systematic review of the quality of life issues associated with anal cancer and its treatment with radiochemotherapy

“…Table 3 outlines the QoL issues identified by the studies. Symptom-related data replicate the findings from toxicity reports although bowel functioning issues, in particular diarrhoea, and sexual problems were the most commonly reported issues in the QoL literature and were presented as significant concerns in seven studies [37,42,38,34,44,29,41]. Allal et al [37] reported a threefold increase in diarrhoea in their cohort compared with population norms while 31% of patients assessed by Das et al [38] D sexual interest (reported in 65% patients) reduced enjoyment of sex (71%), difficulties getting aroused (72%), erectile dysfunction (67% of men who responded) and difficulties achieving orgasm (70% of women who responded) [38].…”

“…Allal et al [37] reported a threefold increase in diarrhoea in their cohort compared with population norms while 31% of patients assessed by Das et al [38] D sexual interest (reported in 65% patients) reduced enjoyment of sex (71%), difficulties getting aroused (72%), erectile dysfunction (67% of men who responded) and difficulties achieving orgasm (70% of women who responded) [38]. Comparisons between anal cancer patients and population norms have also highlighted difficulties in social and role functioning [42,41,44], as well as sexual [44,37,42], physical [44], cognitive [41], and emotional function [41,44] (Table 3). …”

“…Baseline QoL data were provided in one study that compared QoL of a sub-group of 199 patients at baseline and 2 months after treatment as part of the ACCORD 03 trial [36]. Six of the studies assessed QoL in the context of known group comparisons, for example according to age, sex, employment and marital status, treatment type and disease parameters [37,38,34,39,36,40,41]. Comparisons were also made using reference values from published normative data from the general population or other disease groups [42,40,43,41,37,38] while two studies included matched healthy volunteers [42,44].…”

“…Six of the studies assessed QoL in the context of known group comparisons, for example according to age, sex, employment and marital status, treatment type and disease parameters [37,38,34,39,36,40,41]. Comparisons were also made using reference values from published normative data from the general population or other disease groups [42,40,43,41,37,38] while two studies included matched healthy volunteers [42,44]. QoL was a primary end point for 9 studies and for 8 of these studies data on longterm QoL issues were provided with intervals between treatment and assessment varying from 2 years [38] to more than 12 years [44,40].…”

“…Welzel et al [41] addressed patient and disease-related factors related to QoL and found that fatigue was the only variable to have a significant impact on QoL. Toxicities including late complications and anal dysfunction have also been identified as important factors [34,37,38].…”