How patients manage gastrointestinal symptoms after pelvic radiotherapy
- 16 October 2003
- journal article
- website
- Published by Wiley in Alimentary Pharmacology & Therapeutics
- Vol. 18 (10), 987-994
- https://doi.org/10.1046/j.1365-2036.2003.01760.x
Abstract
Background : Approximately 13 000 patients undergo pelvic radiotherapy annually in the UK. It is not clear how frequently patients develop a permanent change in bowel habit after pelvic radiotherapy that affects their quality of life because the measures of gastrointestinal toxicity used in trials in the past have generally been inadequate. It has been suggested that patients who are symptomatic are only rarely referred to a gastroenterologist and it is not known how patients manage their symptoms. Methods : Patients who had completed radiotherapy for pelvic cancer at least 1 year previously were invited to answer 30 structured questions in a face‐to‐face interview to determine the frequency of gastrointestinal symptoms and what orthodox, dietary and complementary therapies they used to deal with them. They were also asked to score the effectiveness of the measures they had taken. Results : One hundred and seven patients were recruited [35 males; median age, 65 years (range, 35–80 years); 72 females; median age, 67.5 years (range, 31–87 years)]. Eight had been treated for a gastrointestinal primary tumour, 34 for a urological tumour and 65 for gynaecological tumours. Eighty‐seven patients (81%) described new‐onset gastrointestinal problems starting after radiotherapy. These symptoms affected the quality of life in 56 patients (52%). Significant effects on the quality of life were caused by diarrhoea or constipation (n = 53), faecal leakage (n = 19), abdominal, rectal or perineal pain (n = 14) and rectal bleeding (n = 6). Fifty‐nine patients had seen a doctor for their symptoms (86% found this helpful), 12 had seen a dietician or nurse (50% found this helpful) and 14 had seen alternative practitioners (88% found this helpful). Dietary manipulation generally did not improve symptoms, except in a small group of patients (14/15) who avoided raw vegetables to great benefit. Conclusions : At least 1 year after pelvic radiotherapy, gastrointestinal symptoms which have an adverse effect on the quality of life may be more common than generally reported. Patients found that advice from doctors and alternative practitioners was equally valuable. Dietary manipulation was generally unhelpful for gastrointestinal symptoms after pelvic radiotherapy, although the role of eliminating raw vegetables may benefit from further evaluation.Keywords
This publication has 26 references indexed in Scilit:
- Chronic Radiation Enteritis: Women's Food Tolerances after Radiation Treatment for Gynecologic CancerJournal of the American Dietetic Association, 2000
- Concurrent chemotherapy and radiation for locally advanced cervical cancer: The new standard of careSeminars in Radiation Oncology, 2000
- ABC of complementary medicine: Users and practitioners of complementary medicineBMJ, 1999
- Morbidities of adjuvant chemotherapy and radiotherapy for resectable rectal cancerDiseases of the Colon & Rectum, 1999
- Epidermoid anal cancer: results from the UKCCCR randomised trial of radiotherapy alone versus radiotherapy, 5-fluorouracil, and mitomycinThe Lancet, 1996
- The Long-Term Effect of Adjuvant Postoperative Chemoradiotherapy for Rectal Carcinoma on Bowel FunctionAnnals of Surgery, 1994
- Chronic effects of pelvic radiation therapy on anorectal functionDiseases of the Colon & Rectum, 1994
- Complementary and conventional cancer care: The integration of two culturesClinical Oncology, 1993
- Chronic diarrhoea after radiotherapy for gynaecological cancer: occurrence and aetiology.Gut, 1991
- Function of the anal sphincters after chronic radiation injury.Gut, 1986