TY - JOUR
T1 - Bowel dysfunction following pelvic organ cancer
T2 - a prospective study on the treatment effect in nurse-led late sequelae clinics
AU - Mekhael, Mira
AU - Larsen, Helene M.
AU - Lauritzen, Michael B.
AU - Thorlacius-Ussing, Ole
AU - Laurberg, Søren
AU - Krogh, Klaus
AU - Drewes, Asbjørn M.
AU - Christensen, Peter
AU - Juul, Therese
N1 - Publisher Copyright:
© 2023 Acta Oncologica Foundation.
PY - 2023/2/9
Y1 - 2023/2/9
N2 - BACKGROUND: Bowel dysfunction following treatment of pelvic organ cancer is prevalent and impacts the quality of life (QoL). The present study aimed to evaluate the feasibility and effects of treating bowel dysfunction in two nurse-led late sequelae clinics.MATERIAL AND METHODS: Treatment effects were monitored prospectively by patient-reported outcome measures collected at baseline and discharge. Change in bowel function was evaluated by 15 bowel symptoms, the St. Mark's Incontinence Score, the Patients Assessment of Constipation-Symptoms (PAC-SYM) score and self-rated bowel function. QoL was evaluated by the EuroQol 5-dimension 5-level (EQ-5D-5L) utility score and by measuring the impact of bowel function on QoL.RESULTS: From June 2018 to December 2021, 380 cancer survivors (46% rectal, 15% gynaecological, 13% anal, 12% colon, 12% prostate, and 2% other cancers) completed a baseline questionnaire and started treatment for bowel dysfunction. At referral, 96% of patients were multisymptomatic. The most frequent symptoms were faecal urgency (95%), fragmented defaecation (93%), emptying difficulties (92%), flatus/faecal incontinence (flatus 89%, liquid 59%, solid 33%), and obstructed defaecation (79%). In total, 169 patients were discharged from the clinics in the follow-up period. At discharge, 69% received conservative treatment only and 24% also received transanal irrigation; 4% were surgically treated; 3% discontinued treatment. Improvements were seen in all 15 bowel symptoms (
p < 0.001), the mean St. Mark's Incontinence Score (12.0 to 9.9,
p < 0.001), the mean PAC-SYM score (1.04 to 0.84,
p < 0.001) and the mean EQ-5D-5L utility score (0.78 to 0.84,
p < 0.001). Self-rated bowel function improved in 56% (
p < 0.001) of cases and the impact of bowel function on QoL improved in 46% (
p < 0.001).
CONCLUSION: Treatment of bowel dysfunction in nurse-led late sequelae clinics is feasible and significantly improved bowel function and QoL.
AB - BACKGROUND: Bowel dysfunction following treatment of pelvic organ cancer is prevalent and impacts the quality of life (QoL). The present study aimed to evaluate the feasibility and effects of treating bowel dysfunction in two nurse-led late sequelae clinics.MATERIAL AND METHODS: Treatment effects were monitored prospectively by patient-reported outcome measures collected at baseline and discharge. Change in bowel function was evaluated by 15 bowel symptoms, the St. Mark's Incontinence Score, the Patients Assessment of Constipation-Symptoms (PAC-SYM) score and self-rated bowel function. QoL was evaluated by the EuroQol 5-dimension 5-level (EQ-5D-5L) utility score and by measuring the impact of bowel function on QoL.RESULTS: From June 2018 to December 2021, 380 cancer survivors (46% rectal, 15% gynaecological, 13% anal, 12% colon, 12% prostate, and 2% other cancers) completed a baseline questionnaire and started treatment for bowel dysfunction. At referral, 96% of patients were multisymptomatic. The most frequent symptoms were faecal urgency (95%), fragmented defaecation (93%), emptying difficulties (92%), flatus/faecal incontinence (flatus 89%, liquid 59%, solid 33%), and obstructed defaecation (79%). In total, 169 patients were discharged from the clinics in the follow-up period. At discharge, 69% received conservative treatment only and 24% also received transanal irrigation; 4% were surgically treated; 3% discontinued treatment. Improvements were seen in all 15 bowel symptoms (
p < 0.001), the mean St. Mark's Incontinence Score (12.0 to 9.9,
p < 0.001), the mean PAC-SYM score (1.04 to 0.84,
p < 0.001) and the mean EQ-5D-5L utility score (0.78 to 0.84,
p < 0.001). Self-rated bowel function improved in 56% (
p < 0.001) of cases and the impact of bowel function on QoL improved in 46% (
p < 0.001).
CONCLUSION: Treatment of bowel dysfunction in nurse-led late sequelae clinics is feasible and significantly improved bowel function and QoL.
KW - bowel dysfunction
KW - Cancer sequelae
KW - nurse-led treatment
KW - pelvic organ cancer
KW - Prospective Studies
KW - Nurse's Role
KW - Humans
KW - Fecal Incontinence/etiology
KW - Male
KW - Treatment Outcome
KW - Constipation/therapy
KW - Quality of Life
KW - Surveys and Questionnaires
KW - Flatulence/complications
KW - Pelvic Neoplasms/complications
UR - http://www.scopus.com/inward/record.url?scp=85147743614&partnerID=8YFLogxK
U2 - 10.1080/0284186X.2023.2168214
DO - 10.1080/0284186X.2023.2168214
M3 - Journal article
C2 - 36757368
AN - SCOPUS:85147743614
SN - 0284-186X
VL - 62
SP - 70
EP - 79
JO - Acta Oncologica
JF - Acta Oncologica
IS - 1
ER -