The clinical needs of patients with chronic gastrointestinal symptoms after pelvic radiotherapy

Aliment Pharmacol Ther. 2007 Aug 15;26(4):555-63. doi: 10.1111/j.1365-2036.2007.03405.x.

Abstract

Background: After radiotherapy for pelvic cancer, gastrointestinal symptoms affecting quality of life are common. How they affect daily living is unknown.

Aim: To investigate the day-to-day impact of gastrointestinal symptoms in patients after pelvic radiotherapy.

Methods: New patients referred for gastroenterological evaluation of radiotherapy-induced symptoms were sent a questionnaire.

Results: Over 15 months, 75 of 100 questionnaires were completed before the gastroenterology appointment by 45 men (median age 70) and 30 women (median age 57) treated for urological (n = 44), gynaecological (n = 27) and gastrointestinal (n = 4) cancers. Time since radiotherapy was 3 years (median) for women and 1.5 years (men). Women experienced 6 (median) symptoms whilst men experienced 4. Having someone listen to problems was often as important as treatment. Urgency, diarrhoea, pain, rectal bleeding, flatulence and bloating were particularly troublesome. 57% women and 33% men were 'very affected'. Symptoms rarely improved with time and in 33% had been present for more than 2 years. Gastrointestinal symptoms affected quality of life through change of routine (F 37%, M 22%), social limitation (F 17%, M 33%), physical limitations (F 33%, M 16%), emotional difficulties (F 47%, M 18%) and sexual problems (F 30%, M 51%).

Conclusions: Patients experience a high number of physical symptoms for long periods before referral. Clinicians must focus systematically on physical, emotional and psychosexual issues.

Publication types

  • Evaluation Study

MeSH terms

  • Activities of Daily Living / psychology
  • Continuity of Patient Care / standards
  • Female
  • Gastrointestinal Diseases / diet therapy
  • Gastrointestinal Diseases / etiology*
  • Gastrointestinal Diseases / therapy
  • Genital Diseases, Female / etiology
  • Humans
  • Male
  • Middle Aged
  • Patient Acceptance of Health Care
  • Pelvic Neoplasms / radiotherapy*
  • Physician-Patient Relations
  • Quality of Life / psychology*
  • Radiotherapy / adverse effects*
  • Surveys and Questionnaires
  • Urologic Diseases / etiology