Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX
Supporting patients undergoing treatment for colorectal cancer in managing side effects and maintaining quality of life involves several key actions:
- Provide comprehensive information about possible side effects: Inform patients about short-term, long-term, permanent, and late side effects such as pain, altered bowel, urinary or sexual function, nerve damage, neuropathy, and mental/emotional changes including anxiety and depression to prepare them for what to expect and how it may affect their quality of life NICE NG151.
- Encourage monitoring and early management of side effects: Emphasise the importance of monitoring side effects during treatment to prevent permanent damage, for example, sensory symptoms after platinum-based chemotherapy that may require dose adjustment NICE NG151.
- Offer tailored symptom management in primary care: Manage bowel dysfunction symptoms (e.g., diarrhoea, urgency, incontinence) with dietary advice, laxatives, anti-diarrhoeal or anti-spasmodic agents, and refer to secondary care if symptoms persist NICE NG151.
- Provide support for specific syndromes: Give information on low anterior resection syndrome (LARS) to patients undergoing sphincter-preserving surgery and assess symptoms using validated questionnaires; offer treatment for associated symptoms in primary care NICE NG151.
- Prepare patients for discharge and recovery: Advise on adapting physical activity, diet modifications to reduce bowel problems, weight management, healthy lifestyle choices (e.g., smoking cessation, alcohol reduction), expected recovery duration, and when and where to seek help if side effects worsen NICE NG151.
- Ensure access to specialist support: Facilitate discussions with appropriate specialists about side effects of surgery including altered bowel, urinary, sexual function, and stoma care if relevant NICE NG151.
- Assess and manage psychological needs: Regularly assess psychological state throughout the illness trajectory and refer promptly to specialist psychological services if significant distress is identified NICE CKS.
- Adopt a systematic approach to symptom assessment and management: Proactively enquire about symptoms, assess their impact on daily life, set achievable treatment goals, and avoid delays in symptom management to maintain quality of life NICE CKS.