Evaluating the functional effects, morbidity, recurrence, survival and quality of life after curative treatment for rectal cancer

Treatment for rectal cancer can be associated with rectal functional impairment, increased morbidity and may impact quality of life. Restorative surgery is the preferred choice of surgery, but in some circumstances, surgery with a permanent stoma is required to ensure tumour clearance. While the aim of treatment for rectal cancer is to ensure cure where possible the long term impact of the functional impact of this treatment is not known. This thesis investigates rectal functional impairment after treatment for rectal cancer in the long-term and its impact on quality of life in rectal cancer compared with age matched colon cancer patients. It also assesses the impact of radiotherapy on this impairment and its effect on quality of life in rectal cancer. In addition, it compares the quality of life in patients with and without a primary stoma after curative surgery for colorectal cancer and determines the impact of country of birth on the perception of a stoma. This thesis finally examines the long term morbidity, local recurrence and survival associated with radiotherapy and provides a protocol for future studies to better evaluate the effects of rectal cancer treatment. Patients treated for rectal cancer have greater rectal functional impairment compared to patients treated for colon cancer. In patients treated for rectal cancer, those receiving radiotherapy had even greater rectal dysfunction. This high rate of rectal dysfunction did not impact on the global quality of life. Patients with a permanent stoma had more restricted physical activity those without a stoma but there were no differences in mental functioning. There were no differences in the overall quality of life associated with country of birth. In this cohort of patients there was no difference in morbidity between those patients who had surgery alone compared with those who had radiotherapy and surgery. The rates of local and distant recurrence were not different between the groups as was overall survival. This thesis has shown that the functional outcomes after treatment for rectal cancer should be an important factor in decision making and that the role of radiotherapy in the treatment of rectal cancer should be re-evaluated.

Grantor dc:publisher

UNSW, Sydney

Year dc:date

2015

Author dc:creator

• Zehra, Faryal

• Morbidity
• Rectal cancer
• Rectal cancer treatment
• Recurrence
• Survival
• Functional outcome
• Intestinal dysfunction
• Quality of life
• Stoma
• Sexual dysfunction
• Preoperative radiotherapy

Statement dc:rights

• open access
• CC BY-NC-ND 3.0
• free_to_read

Licence

• https://purl.org/coar/access_right/c_abf2
• https://creativecommons.org/licenses/by-nc-nd/3.0/au/

Language dc:language

EN

Identifier

https://doi.org/10.26190/unsworks/18349

OAI identifier oai:identifier

oai:unsworks.library.unsw.edu.au:1959.4/54854