Factors Affecting Health Related Quality of Life of Rectal Cancer Patients Undergoing Surgery

Abstract

Maintaining quality of life (QOL) is one of the important aims of cancer treatment. Quality of life of a cancer patient is affected by various factors, which may be disease related, patient related, or treatment related. To study changes in health-related quality of life (HRQOL) brought about by treatment of rectal cancer and factors affecting the changes using Malayalam translation of FACT-C (Functional Assessment of Cancer Therapy-Colorectal) Questionnaire. Also to detect the minimally important clinical changes (MICC) in health-related quality of life of patients with carcinoma rectum, who have undergone surgery. Forty-five patients diagnosed with carcinoma rectum, who have undergone curative surgery, were studied. HRQOL was assessed at baseline 2 weeks after surgery and 3 months after surgery. The changes in scores were correlated with various demographic factors like age, sex, marital status, number of children, number of married children, and education and occupation of the patient and spouse. Also the treatment-related factors like presence of stoma, presence of morbidity, previous treatment, stage of disease, and administration of chemotherapy before and after surgery were correlated. All the subscales of FACT-C tool, except emotional well-being, were significantly reduced 2 weeks after surgery and increased slightly above pre-treatment level 3 months after surgery. The Chronbach α values were 0.88, 0.89 and 0.86 on three occasions, respectively, establishing internal validity of the test. Baseline HRQOL scores were better in males compared to females. Among the various subscales, the drops in SWB, FWB, FACT-G, total Score and TOI were significant (P < .05).There were no significant differences in scores between patients who have undergone open surgery and minimally invasive surgery or patients who had permanent colostomy versus no colostomy. The HRQOL scores after surgery reduced 2 weeks after surgery and improved above pre-surgical levels 3 months after surgery. The approach of surgery (minimally invasive versus open) or presence or absence of permanent colostomy didn't make any significant change in HRQOL. But since the sample size of the study was small, we need further larger studies to arrive at definite conclusions.

Comparison of quality of life outcomes between laparoscopic and open approach for rectal cancer surgery

“…Patients with a colostomy were particularly at risk for dangerous levels of distress because of the "double stigma" of cancer and/or a colostomy. [10] This study examined the change in QoL at 1 week and 1 year after surgical treatment for rectal cancer according to the surgical approach used. There were some significant differences after 1 week following laparoscopy but there was no significant difference in HRQL between the 2 types of procedure at the 12 th month.…”

Validation of Quality of Life Instruments for Cancer Patients – Colorectal Cancer (QLICP-CR) in patients with colorectal cancer in Northeast China

“…Again, items that are positively stated are scored from 0 to 4 points, and negatively stated items from 4 to 0. The scoring guidelines for FACT-C were used to calculate the score of the items, domains, FACT-G and FACT-C total scale [ 18 , 33 ].…”

Baseline Quality of Life of Physical Function Is Highly Relevant for Overall Survival in Advanced Rectal Cancer

“…With the combination of surgery and radiochemotherapy (RCT), very potent treatment options for rectal cancer (RC) are available today. Under the drastic therapy measures, there is temporarily a significant reduction in the patient’s QOL, which generally quickly returns to the initial level after completion of the therapy [ 1 , 2 ]. However, RC is one of the most common cancers in Germany and several thousand patients still die each year [ 3 ].…”