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    Gastrointestinal symptoms after pelvic radiotherapy: a national survey of gastroenterologists.

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    Authors
    Henson, Caroline C
    Davidson, Susan E
    Lalji, A
    Symonds, R P
    Swindell, Ric
    Andreyev, H J
    Affiliation
    Department of Radiotherapy Related Research, The Christie NHS Foundation Trust, Wilmslow Road, Manchester, M20 4BX, UK, caroline.henson@christie.nhs.uk.
    Issue Date
    2011-11-13
    
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    Abstract
    PURPOSE: Seventeen thousand patients receive treatment with radical pelvic radiotherapy annually in the UK. Up to 50% develop significant gastrointestinal symptoms. The National Cancer Survivorship Initiative has identified access to specialist medical care for those with complications after cancer as one of their four key needs. We aimed to determine the current practice of British gastroenterologists with regards to chronic gastrointestinal symptoms after pelvic radiotherapy. METHODS: A questionnaire was developed and sent up to a maximum of five times to all UK consultant gastroenterologists. RESULTS: Eight hundred sixty-six gastroenterologists were approached and 165 (20%) responded. Sixty-one percent saw one to four patients annually with bowel symptoms after radiotherapy. Eighteen percent rate the current treatments as effective "often" or "most of the time". Forty-seven percent of gastroenterologists consider themselves "confident with basic cases", with 11% "confident in all cases". Fifty-nine percent thinks a gastroenterologist with a specialist interest should manage these patients. Although only 29% thinks a specific service is required for these patients, 34% rates the current service as inadequate. The ideal service was considered to be gastroenterology-led, multidisciplinary and regional. Low referral rates, poor evidence-base and poor funding are cited as reasons for the current patchy services. CONCLUSIONS: The low response rate contrasts with that from a parallel survey of clinical oncologists. This may reflect the opinion that radiation-induced bowel toxicity is not a significant issue, which may be because only a small proportion of patients are referred to gastroenterologists. The development of new, evidence-based gastroenterology-led services is considered the optimal way to meet the needs of these patients.
    Citation
    Gastrointestinal symptoms after pelvic radiotherapy: a national survey of gastroenterologists. 2011: Nov 13th Support Care Cancer
    Journal
    Supportive Care in Cancer
    URI
    http://hdl.handle.net/10541/219555
    DOI
    10.1007/s00520-011-1323-5
    PubMed ID
    22081117
    Type
    Article
    ISSN
    1433-7339
    ae974a485f413a2113503eed53cd6c53
    10.1007/s00520-011-1323-5
    Scopus Count
    Collections
    All Christie Publications
    Clinical Oncology

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