Surviving colorectal cancer

Abstract

BACKGROUND.The number of long‐term survivors after a cancer diagnosis is increasing, yet relatively few studies have addressed survivors' reported symptoms beyond the initial year after diagnosis.METHODS.The symptom reports of 474 survivors of colon and rectal cancer from 5 US metropolitan areas were collected during 2002‐2003 as part a larger study of the quality of care for patients with cancer diagnosed in 1998. The relation between the prevalence of reported symptoms and prior treatments received was analyzed, adjusting statistically for other patient characteristics.RESULTS.Sixty‐nine percent of the survivors had colon cancer and 31% had rectal cancer. The most commonly reported symptoms were “fatigue” (23%), “negative feelings about body appearance” (14%), “diarrhea” (13%), and “constipation” (7%). Higher percentages of respondents attributed health effects to cancer or its treatment including “worry about health” (24%), “physical discomfort” (19%), and “activity limitations” (15%). In general, prior treatment was not associated with symptom prevalence. However, radiation therapy recipients and patients that received a diverting ostomy were more likely than others to report some of the symptoms we studied. Attribution of health effects to disease or treatment did not vary by prior treatment except that recipients of radiation therapy were more likely than others to report limitations in their activities (30% vs 10%; P = .003).CONCLUSIONS.Among colorectal cancer survivors the prevalence of symptoms at 4 years was low and relatively comparable to published estimates for the general population, but some survivors continue to attribute health effects to cancer or its treatment. Cancer 2007. © 2007 American Cancer Society.

Cancer survivorship: Advancing the concept in the context of colorectal cancer

“…CRC survivors may experience disparity in care and outcomes of cancer treatment due to ethnicity, age, and access to health insurance, adding a further facet to the individual experience of CRC survivorship (Chambers et al, 2012b;Haggstrom et al, 2009;Schneider et al, 2007;Steginga et al, 2009). Similar to other groups of cancer survivors, the timing, need and ability to process cancer-related information is highly individualized, yet HCP's do not always tailor responses to survivors' circumstances (Anderson et al, 2013;Baravelli et al, 2009).…”

“…Like other tumour groups, CRC survivors may experience pain, sleep disturbance and fatigue (Anderson et al, 2013;Domati et al, 2011;Grant et al, 2011;Grimmett et al, 2011;Jansen et al, 2011;McCaughan et al, 2012;Peddle et al, 2008a;Phipps et al, 2008;Schneider et al, 2007;Shun et al, 2011;Sisler et al, 2012;Stein et al, 2009;Thong et al, 2011bThong et al, , 2013. However, side-effects particular to CRC survivors include weight changes; sexual dysfunction (erectile problems, vaginal dryness, dyspareunia), upper gastrointestinal disturbances (food intolerance, nausea, vomiting, loss of appetite), and bowel dysfunction (constipation, diarrhoea, abdominal cramping, flatulence, incontinence, urgency, frequency) (Anderson et al, 2013;Bailey et al, 2015;Caravati-Jouvenceaux et al, 2011;Den Oudsten et al, 2012;Di Fabio et al, 2008;Ellis et al, 2010;Grant et al, 2011;Grimmett et al., 2011;Jansen et al, 2011;Lynch et al, 2008b;McMullen et al, 2008;Milbury et al, 2013;Nikoletti et al, 2008;Phipps et al, 2008;Ramirez et al, 2009;Ristvedt and Trinkaus, 2009;Sanoff et al, 2015;Schneider et al, 2007;Serpentini et al, 2011;Sisler et al, 2012;Thong et al, 2011aThong et al, , 2011b…”

“…Fear of recurrence, depression, anxiety and distress are enduring issues for some survivors, heightened around the time of clinical appointments (Appleton et al, 2013;Chambers et al, 2012b;Dunn et al, 2013;Esplen et al, 2007;Faul et al, 2012;Krouse et al, 2009;Lawsin et al, 2007;Loi, 2011;Lynch et al, 2008c;McCaughan et al, 2012;Milbury et al, 2013;Nikoletti et al, 2008;Phipps et al, 2008;Ristvedt and Trinkaus, 2009;Schneider et al, 2007;Shun et al, 2011;Stein et al, 2009;Thong et al, 2013). The physical effects of CRC treatment, including bowel dysfunction and peripheral neuropathy had significant negative effects on CRC survivors' psychological well-being, body image, and adaption to survivorship (Bailey et al, 2015;Desnoo and Faithfull, 2006;Ho et al, 2015;McMullen et al, 2008;Padman et al, 2015;Palmer et al, 2013;Phipps et al, 2008;Schneider et al, 2007;Serpentini et al, 2011;Thong et al, 2011b;Tofthagen, 2010). Despite these consequences, some survivors undergo post-traumatic growth.…”

Colorectal Neoplasia Screening Before Age 50?

“…2 The number of Americans with a colorectal cancer diagnosis has increased from 3 to 10 million over the last 30 years. 1 An estimated 148,810 men and women will be diagnosed with colorectal cancer in the United States in 2008, 3 and of those, an estimated 49,960 will die in 2008. 3 Furthermore, an indirect relationship appears to exist between cancer-specific mortality and increased screening methods.…”

Evaluación de las alteraciones psicológicas y de la calidad de vida en pacientes con cáncer colorrectal localizado

“…Los efectos sobre la salud atribuidos a la enfermedad no varían según el tratamiento previo, excepto para aquellas personas con radioterapia, que tuvieron más probabilidades que otras, en las limitaciones de sus actividades diarias (30%) vs los pacientes no recibieron radioterapia (10%). Los supervivientes de cáncer colorrectal tuvieron una prevalencia de síntomas a los 4 años baja y comparable a las estimaciones publicadas sobre la población en general, pero algunos supervivientes continúan atribuyendo los efectos sobre la salud al cáncer o a su tratamiento (Schneider et al, 2007).…”