Literature review: preoperative radiotherapy and rectal cancer - impact on acute symptom presentation and quality of life

Abstract

Aims and objectives: This paper presents a critical review of published literature detailing side effects of preoperative radiotherapy in patients with rectal cancer and the impact of their treatment on their quality of life which will assist in guiding nursing management in the future.

Background: Preoperative radiotherapy for rectal cancer leads to a number of side effects that have a negative influence on patients' quality of life. Although studies have investigated the various adverse effects that can occur, these have not yet been critically appraised and synopsised to form a comprehensive review of their prevalence and effects on the quality of life of patients with rectal cancer.

Design: This literature review study addresses the aims and objectives.

Methods: Following a literature search of electronic databases, 23 articles were retrieved that met the selection criteria with papers discussed in relation to symptoms that present due to this treatment, with six of these 23 studies also referring to health-related quality of life.

Results: Preoperative radiotherapy leads to a number of common adverse effects including diarrhoea, dermatological problems, micturition problems, fatigue, sexual dysfunction and pain. Some can lead to a decline in quality of life during treatment and cause prolonged surgical recovery times, but there appears to be no long-term deterioration in quality of life.

Conclusions: There is a paucity of literature that specifically examines fatigue and quality of life in relation to patients with rectal cancer during preoperative radiotherapy treatment.

Relevance to clinical practice: Awareness of the prevalence and severity of the acute side effects of preoperative radiotherapy will enable nurses to thoroughly assess these symptoms, plan and implement appropriate interventions and evaluate outcomes. This will assist in optimising the quality of life of patients with rectal cancer and may hasten postoperative recovery times.

Keywords: adverse effects; quality of life; radiotherapy; rectal cancer; side effects.