Guiding treatment decisions in bowel cancer
Bowel Cancer More people are living beyond bowel cancer. A new predictive tool is helping patients assess the benefits of treatments against the likely effects on their lives.
“In celebrating increased survival, we can overlook the effects of treatment on people's lives, which can be prolonged and devastating,” says Nick Battersby. Pelican Cancer Foundation Research Fellow and Surgical Registrar in Colorectal and General Surgery.
Surgery close to the rectum can result in bowel function problems such as incontinence, urgency and clustering (going frequently in a short period). .
“This can mean unexpectedly dashing to the toilet and always needing to know where the loo is, which can have a huge impact. Some people never leave home.” says Battersby.
With surgery alone, the risk of bad bowel function is about 45%, but with radiotherapy too, that rises to 66%
The risk of these effects rises when radiotherapy is used as an adjunct to surgery. “With surgery alone, the risk of bad bowel function is about 45%, but with radiotherapy too, that rises to 66%,” he says.
Sometimes treatment options are clear-cut, but in other cases, patients must weigh up treatment benefits against the risk of bad bowel function later. The new POLARS predictive system, devised by Battersby, expresses the risk of poor bowel function in numerical form.
“Knowing the likely effects of their choice helps patients give genuinely informed consent, and enables them to start mentally preparing for life after surgery, and we can discuss strategies to mitigate post-operative effects of treatment, ” says Battersby. “It may also protect doctors by providing quantified evidence of informed consent.”
POLARS is already in use and available free at http://www.pelicancancer.org/bowel-cancer-research/polars