CN68 - Experiences and needs of rectal cancer survivors without or with minor low anterior resection syndrome

Background

After sphincter-saving rectal cancer surgery, many patients experience bowel problems called low anterior resection syndrome (LARS). Especially major LARS (LARS-score ≥ 30) has a negative impact on patients’ quality of life. Our previous research has shown that these patients have several information and counselling needs towards healthcare professionals. Patients without LARS (LARS score 0-20) or with minor LARS (LARS-score 21-29) experience less bowel problems which has less impact on their quality of life. The aim of this study was to explore the dynamics in experiences, information and counselling needs of patients without or with minor LARS.

Methods

A qualitative study based on the principles of a grounded theory was conducted. Rectal cancer survivors without LARS or with minor LARS were purposefully recruited in three large hospitals. Patients with major LARS, patients who have had an abdominoperineal resection with permanent stoma and patients who do not speak Dutch were excluded. Semi-structured interviews were performed. The constant comparative method and investigators’ triangulation were used during data-analysis.

Results

Fourteen patients were interviewed of which six patients without LARS and seven with minor LARS according to the LARS-score. In the first months, all 14 patients experienced LARS which had an impact on their family or working life. However, these symptoms improved over time resulting in a controllable situation. Additionally, patients described that LARS became less dominant and other symptoms such as peripheral neuropathy due to neoadjuvant chemotherapy were perceived worse. Factors such as having previous bowel problems during treatment, comparing themselves to patients experiencing major LARS or feeling euphoria about avoiding a permanent stoma reinforced their coping strategy. The amount of information patients received beforehand varied. Patients who received a high information load experienced anxiety but stated that this information was necessary to be prepared.

Conclusions

The symptoms of patients without or with minor LARS were more controllable and became less dominant compared to major LARS. These insights are important to organize care for patients without or with minor LARS.

Clinical trial identification

BC-11853.

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.