From pelvic radiation to social isolation: a qualitative study of survivors' experiences of chronic bowel symptoms after pelvic radiotherapy.

Autor: Biran A; Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK., Dobson C; Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK., Rees C; Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK., Brooks-Pearson R; Northern Centre for Cancer Care, The Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK., Cunliffe A; South East London Cancer Alliance, London, UK., Durrant L; Somerset NHS Foundation Trust, Taunton, UK., Hancock J; North Tees and Hartlepool NHS Foundation Trust, Stockton-On-Tees, UK., Ludlow H; Cardiff & Vale University Health Board, Cardiff, UK., Neilson L; Department of Gastroenterology, South Tyneside and Sunderland NHS Foundation Trust, South Shields, UK., Wilson A; The Royal Marsden NHS Foundation Trust, London, UK., Sharp L; Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK. Linda.Sharp@newcastle.ac.uk.
Jazyk: angličtina
Zdroj: Journal of cancer survivorship : research and practice [J Cancer Surviv] 2024 Jan 06. Date of Electronic Publication: 2024 Jan 06.
DOI: 10.1007/s11764-023-01527-6
Abstrakt: Purpose: We explored survivors' experiences of chronic bowel symptoms following pelvic radiotherapy, strategies employed in living with these symptoms, effects on daily activities, and roles at home and in the workplace.
Methods: Semi-structured interviews were conducted with 28 individuals (10 gynaecological, 14 prostate, four anal/rectal cancer survivors) who had completed pelvic radiotherapy at least six months prior to data collection and who had experience of bowel symptoms during this post-treatment period. Reflexive thematic analysis was undertaken.
Results: We propose four themes describing a process leading from experience of symptoms to withdrawal from activities and roles. These are (1) losing control (the experience of unintended anal leakage or discharge); (2) experiencing embarrassment and fear (the experience of embarrassment or fear of embarrassment as a result of discharge becoming public); (3) managing and reacting (acting to reduce the likelihood of discharge or to prevent this becoming public); and (4) restriction and withdrawal (avoiding specific activities or situations so as to reduce or remove the risk of embarrassment). Returning to the workplace presented additional challenges across these themes.
Conclusions: Impacts of chronic bowel symptoms can be severe. Survivors employ a variety of methods and strategies in living with their symptoms. Some of these support continued role fulfilment but some constitute a withdrawal from pre-treatment roles. Current healthcare provision and statutory protections fail to fully meet needs following pelvic radiotherapy.
Implications for Cancer Survivors: There is a need to develop and implement evidence-based services and supported self-management programmes for survivors experiencing chronic bowel problems post-radiotherapy.
(© 2024. The Author(s).)
Databáze: MEDLINE
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