Poster Session at ECC 2013 – How to endure life during treatment for colorectal cancer

Birgitte Pedersen et al, Vejle Hospital, Denmark.  Patients with colorectal cancer (CRC) face huge challenges in their everyday lives as a result of their condition and treatments. Rehabilitation is an important part of the management of these patients, and yet there have been no studies documenting the actual patient experience during this journey. A team of nurses at a major oncology centre in Denmark conducted an interview study and reported the results as a poster at this year’s ECCO.

Once diagnosed, the treatment of CRC is multi-factorial and prolonged in nature and side effects and complications quickly become part of everyday life for CRC patients and their families. The team at Vejle Hospital conducted semi-structured interviews with ten CRC patients who had undergone surgery and/or medical treatment in an outpatient setting, using a descriptive phenomenological approach to explore the challenges experienced and how patients coped with their situation.

The results of the interviews suggested a strong element of endurance in the patients’ lives, as they struggled with their on-going treatment, the side effects caused by their medications and the changes in everyday life as a consequence of the disease. Four major themes emerged during the interviews:

–       coping with bodily changes;

–       reorganisation of everyday life;

–       getting support from close relatives;

–       seeing life from a different perspective.

Having daily diarrhoea was seen as having a major impact on patients’ lives and a challenge to their own body image. One patient said: ‘it can be a bit annoying, that you suddenly have to use the toilet – if you think you can defer the decision, forget it.’ It also intruded on the daily routine and forced patients to reorganise their lives to cope, not only with frequent bowel movements but also with strict medication regimes and treatment schedules. As one patient described his daily morning routine: ‘I get up at 6am and take these pills – I then go back to bed and set the alarm for 7.10am. Then I can have time for breakfast before the taxi arrives at 8.30am.’

The CRC diagnosis and treatment also gives rise to thoughts and speculation of a more existential nature that can be a great effort to cope with. All patients in the study felt that their family and close relatives play an important role for providing support and helping them enduring the situation and maintaining a positive outlook on life. One patient mentioned that ‘of course you think about death, but I hope I will stay alive for a long time – there are so many things I want to do – I’m still curious about life.’ Another patient depended on a family member for help with understanding the condition: ‘I talk with my daughter about the things that I think sound quite confusing – she can express it differently and it helps me understand that it’s not that bad.’

In their discussion, the team behind the study pointed out that the results illustrate the importance of initiating nurse-led rehabilitation at the very beginning of CRC treatment, and ensuring patients have access to rehabilitation throughout their treatment course. The rehabilitative care should provide support for the patient in the form of dialogues with the patient and his/her family, on coping with the everyday challenges of CRC disease and treatment.