The cost of survival: an exploration of colorectal cancer survivors’ experiences of pain

Abstract

Background: The Institute of Medicine report 'From Cancer Patient to Cancer Survivor' has drawn widespread attention to the experiences of cancer survivors. Research examining the symptom experiences of survivors are proliferative within the literature but limited by samples which include multiple tumor groups and varying inclusion criteria. This cross-sectional quantitative study seeks to examine pain and quality of life (QoL) in the context of colorectal cancer (CRC) survivorship, as defined by the Institute of Medicine. Material and methods: A purposive sample of CRC survivors (n ¼ 252) attending hospitals and cancer support centers in the Republic of Ireland were recruited between September 2014 and January 2016. Self-rated health (SRH), QoL and pain were assessed in the sample using the EuroQOL questionnaire, the Functional Assessment of Therapy-Colorectal (FACT-C) questionnaire, and symptom experience items. Results: One hundred participants (40%) indicated they had pain on the day of the survey or in the past week. Of those with pain, many also experienced a lack of energy (95%), bowel dysfunction (74%), sleep disturbance (76%) or interference with their ability to enjoy life (75%). Pain was associated with younger age, female gender, current chemotherapy treatment, and previous radiotherapy treatment. Although participants reported positive QoL scores, statistical analysis revealed pain was linked to significantly poorer SRH and overall QoL, and poorer physical, emotional, functional, social/family and CRC-specific wellbeing, compared to those who did not indicate pain. Discussion: Pain was experienced by almost two fifths of CRC survivors up to five years after treatment and was associated with poorer SRH and QoL. In light of these findings, healthcare professionals must endeavor to manage cancer survivors' needs in a manner which is cognizant of the burden of pain and in the context of other symptoms and morbidities experienced by long-term cancer survivors.

<p>Measurement of Health-Related Quality of Life Among Colorectal Cancer Patients Using the Vietnamese Value Set of the EQ-5D-5L</p>

“…42 This result indicated that people with higher levels of education were more conscious of their health, which, in turn, led to less exposure to environmental risk factors, frequent health checkups, and a reduced likelihood of advancement to later cancer stages. 43,44 Furthermore, being younger was recognized as a predictor of poorer HRQoL scores, a finding that was in line with recent studies on other types of cancers; specifically, one study on CRC survivors' pain in the UK 45 and another in Australia. 46 In general, we believe this correlation may reflect patients' life-stage expectations and demands.…”

Associations among marijuana use, health‐related quality of life, exercise, depression and sleep in cancer survivors

“…The prevalence of sleep disturbance and depression in people living with cancer is 40.0%–85.1% and 9.0%–38.2%, respectively (Fortmann et al., 2018; Krebber et al., 2014; Li et al., 2017; Tsaras et al., 2018). Physical, cognitive, and psycho‐emotional symptoms may persist for months post‐treatment (Shi et al., 2011; Vardy et al., 2016), and have been found to greatly interfere with productivity, negatively impacting the quality of life in people living with cancer (Day & Thorn, 2010; Drury et al., 2017). Factors associated with severe symptom phenotype are complex and include age, educational level, cancer type and stage, and sedentary lifestyle (Tsaras et al., 2018).…”

Naringin inhibits colorectal cancer cell growth by repressing the PI3K/AKT/mTOR signaling pathway

“…CRC has demonstrated an increasing incidence in recent years (2). For patients with CRC, postoperative ostomy care is difficult and gastrointestinal function is impaired, resulting in a lower quality of life and increasing the extent of pain during subsequent radiotherapy and chemotherapy (5,6). Therefore, investigating new therapeutic methods for treating CRC, new effective compounds and novel signaling pathways have become areas of focus for research in recent years.…”

“…Furthermore, following surgery, patients often have reduced gastrointestinal function, reduced immunity and also require cumbersome nursing care (5). As a result, the pain caused by subsequent radiotherapy and chemotherapy also increases (6). Therefore, targeted drugs play an important role in the treatment of CRC (7)(8)(9)(10)(11).…”