Skip to main content
SpringerLink
Log in

Factors Affecting Health Related Quality of Life of Rectal Cancer Patients Undergoing Surgery

  • Original Article
  • Published:
Indian Journal of Surgical Oncology Aims and scope Submit manuscript

Abstract

Maintaining quality of life (QOL) is one of the important aims of cancer treatment. Quality of life of a cancer patient is affected by various factors, which may be disease related, patient related, or treatment related. To study changes in health-related quality of life (HRQOL) brought about by treatment of rectal cancer and factors affecting the changes using Malayalam translation of FACT-C (Functional Assessment of Cancer Therapy—Colorectal) Questionnaire. Also to detect the minimally important clinical changes (MICC) in health-related quality of life of patients with carcinoma rectum, who have undergone surgery. Forty-five patients diagnosed with carcinoma rectum, who have undergone curative surgery, were studied. HRQOL was assessed at baseline 2 weeks after surgery and 3 months after surgery. The changes in scores were correlated with various demographic factors like age, sex, marital status, number of children, number of married children, and education and occupation of the patient and spouse. Also the treatment-related factors like presence of stoma, presence of morbidity, previous treatment, stage of disease, and administration of chemotherapy before and after surgery were correlated. All the subscales of FACT-C tool, except emotional well-being, were significantly reduced 2 weeks after surgery and increased slightly above pre-treatment level 3 months after surgery. The Chronbach α values were 0.88, 0.89 and 0.86 on three occasions, respectively, establishing internal validity of the test. Baseline HRQOL scores were better in males compared to females. Among the various subscales, the drops in SWB, FWB, FACT-G, total Score and TOI were significant (P < .05).There were no significant differences in scores between patients who have undergone open surgery and minimally invasive surgery or patients who had permanent colostomy versus no colostomy. The HRQOL scores after surgery reduced 2 weeks after surgery and improved above pre-surgical levels 3 months after surgery. The approach of surgery (minimally invasive versus open) or presence or absence of permanent colostomy didn’t make any significant change in HRQOL. But since the sample size of the study was small, we need further larger studies to arrive at definite conclusions.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8

Similar content being viewed by others

References

  1. Andersson J, Angenete E, Gellerstedt M, Angeras U, Jess P, Rosenberg J, Furst A, Bonjer J, Haglind E (2013) Health-related quality of life after laparoscopic and open surgery for rectalcancer in a randomized trial. The Br j of surg 100(7):941–949

    Article  CAS  Google Scholar 

  2. Braga M, Frasson M, Vignali A, Zuliani W, Civelli V, Di Carlo V (2005) Laparoscopic vs. opencolectomy in cancer patients: long-term complications, quality of life, and survival. Dis Colon Rectum 48(12):2217–2223

    Article  PubMed  Google Scholar 

  3. Cella D, Hahn EA, Dineen K (2002) Meaningful change in cancer-specific quality of life scores: differences between improvement and worsening. Qual of life res : an int j of qual of life aspects of treat, care and rehabil 11(3):207–221

    Article  Google Scholar 

  4. Chandramohan K, Pandey M, Sreerekha KR, Sebastian P, Bejoy CT (2012) Reliability of the Malayalam FACT-colorectal and predictors of QOL in patients with colorectal carcinoma. World J of Psycho-Soc Oncol 1(1):1–4

    Google Scholar 

  5. Cornish JA, Tilney HS, Heriot AG, Lavery IC, Fazio VW, Tekkis PP (2007) A meta-analysis of qualityof life for abdominoperineal excision of rectum versus anterior resection for rectal cancer. Ann Surg Oncol 14(7):2056–2068

    Article  PubMed  Google Scholar 

  6. Cronbach LJ (1951) Coefficient alpha and the internal structure of tests. Psychmnemka 16:297

    Google Scholar 

  7. Da Silva GM, Berho M, Wexner SD, Efron J, Weiss EG, Nogueras JJ, Vernava AM, Connor JT 3rd, Gervaz P (2003) Histologic analysis of the irradiated anal sphincter. Dis of the colon and rectum 46(11):1492–1497

    Article  Google Scholar 

  8. Digennaro R, Tondo M, Cuccia F, Giannini I, Pezzolla F, Rinaldi M, Scala D, Romano G, Altomare DF (2013) Coloanal anastomosis or abdominoperineal resection for very low rectal cancer: what will benefit, the surgeon’s pride or the patient’s quality of life? Int J Colorectal Dis 28(7):949–957

    Article  PubMed  Google Scholar 

  9. Ferlay J, Shin HR, Bray F, Forman D, Mathers C, Parkin DM (2010) Estimates of worldwide burdenof cancer in 2008: GLOBOCAN 2008. Int j of cancer J int ducancer 127(12):2893–2917

    Article  CAS  Google Scholar 

  10. Jayne DG, Guillou PJ, Thorpe H, Quirke P, Copeland J, Smith AM, Heath RM, Brown JM (2007) Randomized trial of laparoscopic-assisted resection of colorectal carcinoma: 3-year results of the UK MRC CLASICC Trial Group. J of clin oncol : off j of the Am Soc of Clin Oncol 25(21):3061–3068

    Article  Google Scholar 

  11. Kang SB, Park JW, Jeong SY, Nam BH, Choi HS, Kim DW, Lim SB, Lee TG, Kim DY, Kim JS et al (2010) Open versus laparoscopic surgery for mid or low rectal cancer after neoadjuvantchemoradiotherapy (COREAN trial): short-term outcomes of an open-label randomisedcontrolled trial. The lancet oncol 11(7):637–645

    Article  Google Scholar 

  12. Lim JF, Tjandra JJ, Hiscock R, Chao MW, Gibbs P (2006) Preoperative chemoradiation for rectalcancer causes prolonged pudendal nerve terminal motor latency. Dis of the colon and rectum 49(1):12–19

    Article  Google Scholar 

  13. Ng SS, Leung WW, Wong CY, Hon SS, Mak TW, Ngo DK, Lee JF (2013) Quality of life after laparoscopic vs open sphincter-preserving resection for rectal cancer. World J Gastroenterol 19(29):4764–4773. doi:10.3748/wjg.v19.i29.4764

    Article  PubMed Central  PubMed  Google Scholar 

  14. Nunnally JC, Bernstein IH (1994) Psychometric theory, 3rd edn. McGraw-Hill, New York

    Google Scholar 

  15. Sprangers MA, Taal BG, Aaronson NK, te Velde A (1995) Quality of life in colorectal cancer. Stoma vs. nonstoma patients. Dis Colon Rectum 38(4):361–369

    Article  CAS  PubMed  Google Scholar 

  16. Ward WL, Hahn EA, Mo F, Hernandez L, Tulsky DS, Cella D (1999) Reliability and validity of theFunctional assessment of cancer therapy-colorectal (FACT-C) quality of life instrument. Qual of life res : an int j of qual of life aspects of treat, care and rehabil 8(3):181–195

    Article  CAS  Google Scholar 

  17. Wyrwich KW, Tierney WM, Wolinsky FD (1999) Further evidence supporting an SEM-based criterion for identifying meaningful intra-individual changes in health-related quality of life. J Clin Epidemiol 52(9):861–873

    Article  CAS  PubMed  Google Scholar 

  18. Yost KJ, Sorensen MV, Hahn EA, Glendenning GA, Gnanasakthy A, Cella D (2005) Using multipleanchor- and distribution-based estimates to evaluate clinically meaningful change on the functional assessment of cancer therapy-biologic response modifiers (FACT-BRM)instrument. Value Health 8(2):117–127

    Article  PubMed  Google Scholar 

Download references

Acknowledgement

Ms Rekha Jayasankar, Research Assistant

Author information

Authors and Affiliations

  1. Department of Surgical Oncology, Regional Cancer Centre, Trivandrum, India

    C. Krishnan Nair, K. S. Rethnamma, R. Bhargavan, A. P. Mathew, M. Muralee, K. Cherian, P. Augustine & M. I. Ahamed

  2. Department of Bio-Statistics, Regional Cancer Centre, Trivandrum, India

    P. S. George

  3. Department of Radiotherapy, Regional Cancer Centre, Trivandrum, India

    S. Abdul Rahman

Authors
  1. C. Krishnan Nair
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. P. S. George
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. K. S. Rethnamma
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. R. Bhargavan
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. S. Abdul Rahman
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. A. P. Mathew
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. M. Muralee
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. K. Cherian
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. P. Augustine
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. M. I. Ahamed
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to C. Krishnan Nair.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Nair, C.K., George, P.S., Rethnamma, K.S. et al. Factors Affecting Health Related Quality of Life of Rectal Cancer Patients Undergoing Surgery. Indian J Surg Oncol 5, 266–273 (2014). https://doi.org/10.1007/s13193-014-0346-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13193-014-0346-z

Keywords

Search

Navigation