Constipation, diarrhoea common problems of anal cancer patients

Anal cancer patients commonly suffer from gastrointestinal symptoms such as constipation and diarrhoea, which can lead to pain, a recent Germany study has found. Their functional scores are also lower than in the general population, but this does not seem to negatively impact their quality of life (QoL).

Fifty-two patients (median age 64.5 years, 38 women) participated in the study. All had undergone definitive chemoradiation for anal cancer. Cancer-specific QoL was measured using the EORTC QLQ‑C30; the newly developed QLQ-ANL27 tool was also used to assess anal cancer-specific QoL.

Compared with the German reference population, anal cancer patients showed significantly weaker role (mean, 70.5 vs 82.7 points; p=0.000), emotional (mean, 70.5 vs 77.1 points; p=0.000), and social (mean, 83.0 vs 89.8 points; p=0.009) functioning. In contrast, patients displayed significantly better cognitive functioning (mean, 95.8 vs 88.6 points; p=0.041) and overall global health (mean, 77.6 vs 63.4 points; p=0.000).

Of note, radiation-associated constipation (p=0.002) and diarrhoea (p=0.000) were both likewise worse in anal cancer patients. No other symptom showed a similar effect.

In terms of site-specific QoL, patients who experienced tumour relapse showed significantly worse symptom scores than counterparts who achieved complete clinical remission. Moreover, treatment with intensity-modulated radiotherapy seemed to result in better non-stoma bowel function and female sexual functioning, while inducing less pain and concerns about toilet proximity and cleanliness.

“Most of the functional scores of anal cancer patients were lower compared to those of the general German population, but did not seem to affect the general QoL. Fatigue, physical complaints, and role behaviours had the strongest influence on global quality of life, so psychological symptoms were as important as physical symptoms,” the researchers said.