Quality of life acceptable after anal cancer - except for sexual function

NEW YORK (Reuters Health) - Two or more years after radiotherapy for anal cancer, overall quality-of-life (QOL) scores are acceptable in most patients but sexual function scores tend to be poor, new research shows.

In addition, "a significant percentage of patients" had difficulty with diarrhea and bowel control, and younger patients had worse QOL.

These findings, reported online December 29 in Cancer, are from a survey completed by 32 patients who were treated for nonmetastatic squamous cell cancer of the anal canal at the University of Texas M.D. Anderson Cancer Center in Houston. The questionnaire was originally sent to 80 patients.

According to lead author Dr. Prajnan Das and colleagues, there was no significant difference in clinical or demographic factors between survey responders and nonresponders. The median interval from therapy to participation in the survey was 5 years.

On the Functional Assessment of Cancer Therapy-Colorectal (FACT-C) instrument (maximum score 136; higher score indicating better QOL), the median total score was 108, with subjects younger than 51 years reporting significantly worse scores than older patients (106 vs 114, p = 0.033).

Patients with a history of depression or anxiety also had significantly lower total FACT-C scores compared with patients without this history (median score 92 vs 109, p = 0.006). Patients with a history of other cancers had significantly lower scores on the Physical subscale of FACT-C.

On the Medical Outcomes Study (MOS) Sexual Problems Scale (maximum score 100; higher scores indicating worse sexual function), the median score was 67. Except for a trend toward worse scores in subjects 51 years or younger and in those with a colostomy, no factors were significantly associated with MOS Sexual Problems Scale score.

A significant number of patients reported problems with diarrhea (31%), bowel control (23%), and various aspects of sexual function (55%), such as an inability to relax or enjoy sex, difficulty in becoming sexually aroused, obtaining or maintaining an ejection, and ability to have an orgasm.

The time from treatment was not significantly associated with any of the outcomes.

"The results of the current study indicate that more emphasis needs to be placed on identifying and addressing treatment-related symptoms after chemoradiation for anal cancer," the researchers conclude. "Long-term follow-up of these patients is necessary to identify and treat the consequences of successful cancer therapy."

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