Background

As survival rates continue to increase for many cancers, it is important that we develop a good understanding of the long term and late effects of treatments and find ways to maximise the quality of life of cancer survivors.  Pelvic radiotherapy is a common cancer treatment and yet relatively little is known of the long term impact.

Aims

To estimate the prevalence of late effects of pelvic radiotherapy in a sample of long term cancer survivors, and to assess the impact of  time since treatment on symptom prevalence.  To explore the relationship between symptoms, psychological morbidity and quality of life.  

Method

Questionnaire study to a random sample of cancer survivors who had pelvic radiotherapy 1-11 years previously in Oxford.  The questionnaire measured patient-reported toxicity (CTCAE), psychological morbidity (HADS) and quality of life (EORTC QLQ-30).  Mutiple linear regression was used to explore associations.

Findings

We received 418 completed questionnaires (RR = 55.6%).  Moderate /severe problems in relation to bowel urgency (59% females, 45% males), urine urgency (49% females, 46% males) and ability to have a sexual relationship (24% females, 53% males) were commonly reported.  Symptoms were just as frequent in those 6-11 years post-treatment as in those 1-5 years post-treatment. Symptom severity was signficantly associated with poorer overall quality of life, and higher levels of depression. 

Conclusions

Persistent effects are common amongst long term cancer survivors who have had pelvic radiotherapy, and are associated with reduced quality of life and psychological morbidity.  It is imperative due attention is paid to this issue during the follow-up phase, both in secondary and primary care, and that the relevant health professionals are appropriately educated on this topic.