Colon cancer survivors are living longer than ever, but the vast majority of women treated for the disease have lingering gastrointestinal symptoms, such as bloating and gas, new research reveals.
Roughly eight years after treatment, 81% of female colon cancer survivors still had GI symptoms, say researchers who analyzed medical data from more than 400 women.
Severe GI symptoms were linked to poor quality of life, interference with daily social and physical activities and low body image satisfaction.
"Many cancer treatments show great success, and many cancer survivors are living longer than ever before,"said lead study author Claire Han, an assistant professor of nursing at Ohio State University.
"GI symptoms among survivors have been under-investigated in the past, but we found that they are very prevalent, even up to 25 years after diagnosis, suggesting it's very important to consider GI symptom management as part of their survivorship care,"Han said in a university news release.
The analysis was not able to identify the reasons for the symptoms, and it's not known if the disease itself or treatments such as surgery or chemotherapy played a significant role. The location of cancer in the colon and rectum and treatment-related effects on the gut and the microbes living there could be a factor, Han said.
The women studied also had psychological distress, which is common for cancer survivors. The study couldn't tease out whether the gut issues were contributing to this distress.
"Cancer survivors with high psychological symptoms may have a higher stress level that could inflame the gut and lead to GI symptoms,"Han said. "The causal direction could be bidirectional -- which comes first doesn't really matter because both types of symptoms are present."
The data was from 413 postmenopausal colon cancer survivors in the Women's Health Initiative's (WHI) Life and Longevity After Cancer (LILAC) study. The average time since diagnosis was eight years.
About 63% had undergone surgery for their cancer and more than one-third had received multiple treatments, including surgery and chemoradiation.
According to the study, about 54% had abdominal bloating and gas, and for 17% this was moderate to severe. About 44% had constipation, including almost 13% with moderate to severe symptoms. Roughly one-third had diarrhea and nearly 29% had abdominal/pelvic pain. About 15% of survivors reported moderate to severe overall GI symptoms.
Persistent GI symptoms were more likely for women with stage 3 cancer within five years after diagnosis. More severe depression, anxiety, fatigue and sleep problems was reported by the women with GI issues than those without.
The results show a need for psychosocial support, pain management, nutrition counseling and physical rehabilitation for survivors of colon cancer, Han said.
Five-year survival for all stages of colon cancer is 64%. For people with early-stage cancer -- cancer that has not spread -- it is over 90%, according to the American Cancer Society.
The WHI is funded by the U.S. National Heart, Lung, and Blood Institute. The study was published recently in the journal PLOS ONE.
More information
The American Cancer Society has more on colon cancer.
SOURCE: Ohio State University, news release, Aug. 1, 2023
