Patient-reported toxicity after colorectal cancer (CRC) treatment.

Abstract

484 Background: Colorectal cancer patients may be at risk for myriad late effects after multimodality therapy, the impact of which may difficult to evaluate using conventional methods. This Internet-based study evaluates patient perceptions of toxicity after treatment for CRC. Methods: Patient-reported data was gathered via a convenience sample frame from CRC survivors voluntarily utilizing a publically available, free, Internet-based tool for creation of survivorship care plans. Available at www.livestrongcareplan.com and through the OncoLink website, the tool allows survivors to enter data regarding diagnosis, demographics, and treatments, and provides customized guidelines for future care. During use of the tool, CRC survivors are queried regarding late effects associated with specific treatments, and asked to answer “yes,” “no,” or “I don't know.” They are also asked to score GI toxicity using WHO criteria. All data have been maintained with IRB approval. Results: 148 CRC survivors answered queries regarding late effects; 64% were female and 82% Caucasian. Median diagnosis age was 50 (24-76) and median current age 54 (24-77). Most reported having had multimodality therapy - 97% surgery, 89% chemotherapy, and 37% radiation. When queried regarding GI toxicity, 51% reported chronic changes in bowel patterns, 34% chronic diarrhea, 12% bowel obstruction, 18% hernia development, 8% radiation colitis, and 2% fistula formation. Of 18 survivors who graded GI toxicity, 27% reported 4-6 stools per day, and 22% > 6 stools per day or incontinence. When queried regarding sexual function, 31% of men reported worse erectile function than pre-treatment, and 39% of women reported sexual changes such as vaginal dryness. Perceived cognitive decline since diagnosis of cancer was reported by 57%. Conclusions: Survivors using this tool anonymously and voluntarily report significant GI toxicity after cancer treatment. Approximately 1/3 of male and female survivors report impact on sexual function, and more than 50% report perceived cognitive decline. This tool offers a unique way for survivors to report their experiences; the data reported here may be of significant impact in future study of quality of life, as well as patient counseling and survivor care. No significant financial relationships to disclose.