title: Qualitative assessment of patient experiences related to extended pelvic resection for rectal cancer.
abstract: BACKGROUND
  Patients with locally advanced rectal cancer (LARC) and locally recurrent rectal cancer (LRRC) represent a complex management challenge. While there is potential for cure in a subset of patients, the cost in terms of morbidity can be high. Few descriptions of the physical, psychological, social, and emotional experiences of these patients exist.
  
  
  METHODS
  Face-to-face interviews were completed with ten LARC and LRRC patients treated with multimodal therapy that included surgery. Patient opinions and experiences were explored in depth until information redundancy and common themes were delineated using qualitative research methods. Clinical information was obtained from the database.
  
  
  RESULTS
  Nine of the ten patients were male, seven had LARC, and the median age was 71. Six themes were identified from the patient interviews. Themes reflected patients' highly focused desire to seek wellness and cure, but also revealed misunderstanding of their disease biology, probability of cure, therapeutic options, and treatment morbidity.
  
  
  CONCLUSIONS
  Patient experiences confirm that this is challenging treatment to complete, and that patient understanding of pre-operative information is incomplete. Our findings underscore the need for a multidisciplinary approach when managing this patient population, with emphasis on both supportive care needs and the technically skilled delivery of surgery, chemotherapy, and radiotherapy.
authors.affiliation: Division of Surgical Oncology, Sunnybrook and Women's College Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.
authors.forename: F C
authors.initials: FC
authors.lastname: Wright
authors.forename: D
authors.initials: D
authors.lastname: Crooks
authors.forename: M
authors.initials: M
authors.lastname: Fitch
authors.forename: E
authors.initials: E
authors.lastname: Hollenberg
authors.forename: B A
authors.initials: BA
authors.lastname: Maier
authors.forename: L D
authors.initials: LD
authors.lastname: Last
authors.forename: E
authors.initials: E
authors.lastname: Greco
authors.forename: D
authors.initials: D
authors.lastname: Miller
authors.forename: C H L
authors.initials: CH
authors.lastname: Law
authors.forename: S
authors.initials: S
authors.lastname: Sharir
authors.forename: N E
authors.initials: NE
authors.lastname: Fleshner
authors.forename: A J
authors.initials: AJ
authors.lastname: Smith
mesh_terms: D000328:Adult; D000368:Aged; D017024:Chemotherapy, Adjuvant; D015331:Cohort Studies; D003125:Colostomy; D003131:Combined Modality Therapy; D003657:Decision Making; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000523:psychology* / Q000601:surgery*; D005791:Patient Care; D010385:Pelvic Exenteration; D011446:Prospective Studies; D018714:Radiotherapy, Adjuvant; D012004:Rectal Neoplasms / Q000401:mortality / Q000523:psychology* / Q000601:surgery*; D012944:Social Support; D015996:Survival Rate