Health-related quality of life and sexual function in patients with rectal cancer

The aim of this study was to compare health-related quality of life in healthy individuals and patients with rectal cancer.

Rectal cancer is one of the most common cancers worldwide. Beyond the cancer symptoms it is now well recognized that having cancer can also affect patients’ quality of life. A number of underlying causes can lead to decline in quality of life: mental stress, physical stress and side effects of treatment.

Different categories of rectal cancer exist. Non-advanced rectal cancer means the cancer has not spread beyond the rectum. Locally advanced cancer means the tumor has spread further through the wall of the rectum or into nearby lymph nodes. Locally recurrent rectal cancer involves return of the cancer close to the original site after initial treatment. Although it is now widely accepted that cancer can lead to poor quality of life, the implication of treatment for these various categories of rectal cancer has not been well researched.

This study included 80 patients with non-advanced rectal cancer, 292 patients with locally advanced rectal cancer and 67 patients with locally recurrent cancer. A group of 350 healthy individuals were included for comparison.

The type of treatment differed between the 3 groups of patients with rectal cancer. 86.3% of patients with non-advanced cancer received neoadjuvant radiotherapy (radiotherapy before surgery). 84.6% of patients with locally advanced cancer received neoadjuvant chemoradiation (chemotherapy and radiation before surgery). 56.7% of patients with locally recurrent cancer received re-irradiation and chemotherapy.

Health-related quality of life and sexual function was most significantly affected in patients with locally recurrent rectal cancer. Their physical function, social function, body image, sexual function, pain and future perspective was worse than for the other groups of patients. Male patients with locally recurrent rectal cancer had more problems with sexual function than female patients: erectile problems and ejaculatory dysfunction. Males also reported decreased sexual activity after surgery.

The authors concluded that patients being treated for rectal cancer had lower health related quality of life and sexual function than healthy individuals. Patients being treated for locally recurrent rectal cancer had the lowest health related quality of life.