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Gastrointestinal symptoms after pelvic radiotherapy: a national survey of gastroenterologists

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Abstract

Purpose

Seventeen thousand patients receive treatment with radical pelvic radiotherapy annually in the UK. Up to 50% develop significant gastrointestinal symptoms. The National Cancer Survivorship Initiative has identified access to specialist medical care for those with complications after cancer as one of their four key needs. We aimed to determine the current practice of British gastroenterologists with regards to chronic gastrointestinal symptoms after pelvic radiotherapy.

Methods

A questionnaire was developed and sent up to a maximum of five times to all UK consultant gastroenterologists.

Results

Eight hundred sixty-six gastroenterologists were approached and 165 (20%) responded. Sixty-one percent saw one to four patients annually with bowel symptoms after radiotherapy. Eighteen percent rate the current treatments as effective “often” or “most of the time”. Forty-seven percent of gastroenterologists consider themselves “confident with basic cases”, with 11% “confident in all cases”. Fifty-nine percent thinks a gastroenterologist with a specialist interest should manage these patients. Although only 29% thinks a specific service is required for these patients, 34% rates the current service as inadequate. The ideal service was considered to be gastroenterology-led, multidisciplinary and regional. Low referral rates, poor evidence-base and poor funding are cited as reasons for the current patchy services.

Conclusions

The low response rate contrasts with that from a parallel survey of clinical oncologists. This may reflect the opinion that radiation-induced bowel toxicity is not a significant issue, which may be because only a small proportion of patients are referred to gastroenterologists. The development of new, evidence-based gastroenterology-led services is considered the optimal way to meet the needs of these patients.

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Acknowledgements

We acknowledge NHS funding to the NIHR Biomedical Research Centre at the Royal Marsden Hospital. The salary of the data manager is paid by a grant from the Research for Patients’ Benefit fund of the NIHR and by the Royal Marsden NHS Foundation Trust Charitable Funds. Dr Caroline Henson is funded by Macmillan Cancer Support. The authors would like to thank Ric Swindell and Mrs Rita Hannon for their help with analysis of the data.

Conflict of interest

None declared.

Author information

Authors and Affiliations

  1. Department of Radiotherapy Related Research, The Christie NHS Foundation Trust, Wilmslow Road, Manchester, M20 4BX, UK

    C. C. Henson

  2. Department of Clinical Oncology, The Christie NHS Foundation Trust, Wilmslow Road, Manchester, M20 4BX, UK

    S. E. Davidson

  3. Department of Statistics, The Christie NHS Foundation Trust, Wilmslow Road, Manchester, M20 4BX, UK

    R. Swindell

  4. Department of Gastroenterology, Royal Marsden NHS Foundation Trust, London, UK

    A. Lalji & H. J. N. Andreyev

  5. Department of Clinical Oncology, Leicester Royal Infirmary, Leicester, UK

    R. P. Symonds

Authors
  1. C. C. Henson
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  2. S. E. Davidson
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  3. A. Lalji
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  4. R. P. Symonds
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  5. R. Swindell
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  6. H. J. N. Andreyev
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Corresponding author

Correspondence to C. C. Henson.

Appendix 1: Gastroenterologists’ survey

Appendix 1: Gastroenterologists’ survey

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Henson, C.C., Davidson, S.E., Lalji, A. et al. Gastrointestinal symptoms after pelvic radiotherapy: a national survey of gastroenterologists. Support Care Cancer 20, 2129–2139 (2012). https://doi.org/10.1007/s00520-011-1323-5

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  • DOI: https://doi.org/10.1007/s00520-011-1323-5

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