Quality of life in colorectal cancer patients with stoma or adjuvant therapy.

Abstract

Dear Editor, Colorectal cancer is one of the most common cancers worldwide. In Singapore, 9,324 new cases of colorectal cancer were diagnosed in 2010–2014, and it is the most common cancer among men (17.2% of cancer burden).1 Compared to the period 2005–2009, there was an increase in the overall survival of all colorectal cancer patients in 2010–2014 (from 46.0% to 51.0%).1 This trend may be due to earlier diagnosis of colorectal cancer and advances in multimodality treatment of the disease over the past few years. Besides disease-free survival, quality of life (QoL) has emerged as an important outcome measure for cancer patients. Colorectal cancer patients may undergo surgery, radiotherapy, chemotherapy, or a combination of these modalities. These treatments can have longand short-term effects and complications, resulting in a decrease in the QoL of cancer survivors; studies have reported the physical and psychological problems faced by cancer patients due to both disease and treatment.2,3 In addition, rectal cancer patients are also thought to have a higher incidence of decreased QoL due to the risk of developing anal impairment.4 Nonetheless, there is a paucity of studies examining the consistency of these findings within an Asian setting. This cross-sectional exploratory study therefore aims to evaluate the QoL of colorectal cancer patients after diagnosis and treatment, focusing on the impact of chemotherapy or radiotherapy (chemo/RT) and creation of stoma. The purposive sample of our study consisted of 100 patients who were above 21 years of age, had been diagnosed with colorectal cancer, and had undergone treatment within the National University Hospital, a tertiary hospital in Singapore. Patient eligibility was assessed using the hospital’s clinical management system. The research team identified and recruited eligible patients between October 2015 and May 2016 when they presented for follow-up at the hospital’s colorectal outpatient clinics. Written informed consent was obtained from participants before the administration of a pen-and-paper survey consisting of three sections: (1) participant sociodemographic characteristics, (2) type(s) of treatment undergone, and (3) the European Organisation for Research and Training of Cancer Quality of Life Questionnaire (EORTC QLQ-C30).5 The EORTC QLQ-C30 is a 30-item patient questionnaire on general quality of life for cancer patients.6,7 The EORTC QLQ-C30 has demonstrated high validity and reliability scores when adapted for use in Asian populations.8-10 The present research only utilised the Global Health Status subscale, which corresponds to QoL. This was scored on a range of 0 to 100, in which 100 denotes perfect QoL.