Bowel dysfunction in survivors of gynaecologic malignancies

Abstract

Purpose To assess the prevalence of bowel dysfunctions after treatment for gynaecological cancer and the impact on the quality of life. Methods We identified a cohort of 217 eligible women treated with radiotherapy (RT) with curative intention, alone or as combined treatment, for gynaecological malignancies at three institutions in Catalonia (Spain). Demographic, diagnosis and treatment modality were reviewed. Patients were sent validated questionnaires to assess bowel function and a set of questions asking on the changes after RT in bowel function, urinary function, sexuality, pain and lymphoedema. Results Questionnaires were returned by 109 patients (50.2%) with a mean age of 65 ± 11 years. Of them, 71.8% had been treated for endometrial cancer and 28.2% for cervical cancer. Overall, 42.7% of patients reported bowel dysfunction, affecting their quality of life in 36% of cases. Symptoms were more frequent in patients who had undergone external beam RT compared to brachytherapy. The most common symptom was defecatory urgency which was reported by more than 40% of patients according to the St Mark's score, although it was less common in other questionnaires. Overall, faecal incontinence ranged between 10 and 15%, and usual loose stools and diarrhoea were reported by 13.5% and 5.1%, respectively. Conclusion Prevalence of bowel symptoms after treatment of gynaecological malignancies is high. A systematic evaluation using validated questionnaires should be performed in order to allow the decision-making process and also because there are a number of treatments available to improve the quality of life of cancer survivors.

Sexual health and wellbeing among female pelvic cancer survivors following individualized interventions in a nurse-led clinic

“…Previous research in women with non-malignant diseases reports associations between impaired intestinal function and sexual health [19,20]. In women with a history of gynecological cancer, the presence of intestinal late effects, such as fecal leakage and loose stools, is reported to severely impair quality of life [21,22]. Living with fecal incontinence may lead to the avoidance of being in or embarking on relationships that might lead to sexual intimacy [23].…”