Late effects and quality of life after chemo-radiation for the treatment of anal cancer.
OBJECTIVE
The aim of this study was to evaluate the late effects and quality of life of patients following chemo-radiation treatment for anal cancer.


METHODS
All surviving anal cancer patients treated within NHS Lothian between 1990 and 2007 were invited to participate. Data were collected using the EORTC QLQ-C30, the EORTC QLQ-CR38 and the Memorial Sloan-Kettering Cancer Centre Bowel Function Instrument (MSKCC).


RESULTS
Overall response rate was 46% (n = 42); mean age 54.7 years and with a median time interval of 63.8 months between treatment and completion of the questionnaires. Thirty-five percent of the participants were 'rarely' or 'never' able to wait 15 min to get to the toilet; 50% were 'rarely' or 'never' able to control the passage of gas; 35% limited the types of solid foods they eat; 22% had leakage of stool during the day; 39% required to use a protective pad and 29% altered their daily activities because of bowel function 'always' or 'most of the time'. Seventeen percent of patients reported financial difficulties ('quite a bit' and 'very much'). Both men and women reported high symptomology for sexual problems with a median score of 83.3 (50.0. 100.0).


CONCLUSIONS
This study has shown that in a sub-set of patients treated with chemo-radiation for anal cancer, persistent treatment related issues are reported at a medium time interval of 5.3 years. Further work is now required to understand the impact of symptoms on day-to-day life and the challenges that people face in managing these inter-related and complex problems.
Edinburgh Cancer Centre, Lothian University Hospitals Division, Western General Hospital, Crewe Road, Edinburgh, EH4 2XU, UK. Electronic address: gillian.knowles@luht.scot.nhs.uk.
Gillian
G
Knowles
Edinburgh Cancer Centre, Lothian University Hospitals Division, Western General Hospital, Crewe Road, Edinburgh, EH4 2XU, UK. Electronic address: rachel.haigh@luht.scot.nhs.uk.
Rachel
R
Haigh
Edinburgh Cancer Centre, Lothian University Hospitals Division, Western General Hospital, Crewe Road, Edinburgh, EH4 2XU, UK. Electronic address: catriona.mclean@luht.scot.nhs.uk.
Catriona
C
McLean
Edinburgh Cancer Centre, Lothian University Hospitals Division, Western General Hospital, Crewe Road, Edinburgh, EH4 2XU, UK. Electronic address: hamish.phillips@luht.scot.nhs.uk.
Hamish
H
Phillips
D000328:Adult; D000368:Aged; D001005:Anus Neoplasms / Q000473:pathology / Q000523:psychology / Q000628:therapy*; D059248:Chemoradiotherapy / Q000009:adverse effects* / Q000379:methods / Q000523:psychology; D016208:Databases, Factual; D003672:Defecation / Q000502:physiology; D005242:Fecal Incontinence / Q000209:etiology* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012189:Retrospective Studies; D018570:Risk Assessment; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires; D017741:Survivors; D013997:Time Factors
Anal cancer; Consequences of treatment; Late effects; Pelvic chemo-radiation