| Abstract | Survival from cancer is becoming a reality for more people in the world each year. Survival rate from colorectal cancer disease is approximately 80% one year after diagnosis, but falls to 62% at 5 years from diagnosis. Quality of life research in colorectal cancer to date has focused on investigating patients' experience during the diagnostic or treatment phase while the experiences of those who have survived this cancer have been ignored.
Based on the concept of Health-Related Quality of Life (HRQOL) this study was focused on understanding and assessing the impact of colorectal cancer disease and its treatment on Greek patients' HRQOL over time. Also, this study sought to identify multiple factors (related either to patient or disease characteristics) that contributed to patients' HRQOL in both specific and general domains. Age, gender, stage at diagnosis, time elapse since diagnosis, income, education, colostomy appliance, disease recurrence, depression and communication between couples were examined for their effect on HRQOL over time. 145 Greek outpatients (male 87, female 58) completed the Functional Assessment of Cancer Therapy-Colorectal (FACT-C) Quality of Life Instrument and the Mental Component of the Short Form 36 Health Survey questionnaire measuring both generic and disease-specific HRQOL, as well as the Center for Epidemiologic Studies Depression Scale (CES-D) to detect depressive symptoms, and the Enriching & Nurturing Relationship Issues, Communication & Happiness (ENRICH) scale to assess communication between couples, at an interval of either one year or more than 5 years since diagnosis. Statistical significance was set at (p<0.05) and data were analysed using the Statistical Package for the Social Sciences (SPSS).
The findings suggest that patients who survived colorectal cancer experienced an overall high quality of life independent of the stage of disease at diagnosis or time since diagnosis. Among those factors that had a negative effect on patients overall HRQOL over time depression was the most prevalent. Stoma patients experienced an overall lower HRQOL than non-stoma patients. Most domains of HRQOL assessment such as
physical, emotional and role functioning of stoma patients were negatively affected, but these did not reach statistical significance. Notably, stoma patients in this sample showed significantly more dissatisfaction with body image than patients without a stoma – a finding that was more prevalent in women. This may suggest that stoma formation negatively affects sexual function and body image. Finally, patients with lower incomes
and a recurrence or metastatic disease also experienced a poorer HRQOL.
It is recommended that a practice-based strategy is developed in Greece to assess the HRQOL and psychosocial functioning of these patients as well as the recommendation that in the preoperative stage, after surgery and in the rehabilitation phase for stoma patients to be assessed and supported by a specialist Stoma Care nurse. Other suggestions for future research are also proposed. |
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