“Their Whole Lives Are Going To Change”: A Photo-Elicitation Study of Rectal Cancer Survivorship

Abstract

BACKGROUND:Rectal cancer survivors experience persistent symptoms, which may lead to unmet needs. OBJECTIVE:This study aimed to explore the rectal cancer survivor experience and identify the impacts of treatment using photo-elicitation. DESIGN:This was a novel study in which patients were instructed to take photographs that showed aspects of life that have been challenging to deal with since undergoing treatment. Participants underwent subsequent qualitative interviews using the photographs as prompts. SETTING:The study was conducted in a cancer center in a tertiary medical center.PATIENTS: Twenty patients were included who underwent curative-intent rectal cancer treatment. MAIN OUTCOME MEASURES:Interviews were designed to explore the lived experiences of patients with rectal cancer after treatment.RESULTS: Three major themes with regard to life after rectal cancer and its treatments emerged: physical symptoms, lifestyle changes, and changes over time. Physical symptoms encompassed GI issues, ostomy difficulties, and genitourinary symptoms. Lifestyle changes included those relating to diet, social life, and hobbies as well as major life changes and finances. Finally, patients spoke of improvement during the time of symptoms and impact on daily life. LIMITATIONS:There may be bias because of the homogeneity of our study population, which may not represent the experiences of younger patients, those of lower socioeconomic status, or those who chose not to participate. Our sample was also overrepresented by patients with a complete pathologic response after neoadjuvant chemotherapy and excluded individuals with recurrence. Finally, single interviews with each individual at different points from their treatment may have resulted in recall bias. CONCLUSIONS:This photo-elicitation study provided rectal cancer survivors with a unique opportunity to share how rectal cancer treatment has impacted their lives beyond traditional metrics such as postoperative complications and long-term survival. In addition to improving preoperative counseling and expectation setting, future efforts should focus on postoperative symptom surveillance and appropriate referral when needed.

Life After Rectal Cancer Treatment: Time to Turn to the Experts

“…Although we have a sense of the timeline to a “new normal” when it comes to bowel movements, the data regarding adjustment to life after treatment (what, how, how long) are very thin. This is the challenge that Rivard et al 3 take up in their innovative study of rectal cancer survivors.…”