Approximately 18% of patients with colorectal cancer (CRC) are diagnosed with advanced cancer, while 30-40% develop recurrent disease after treatment with curative intent. Recent surgical treatments (e.g., cytoreductive surgery and hypothermic intraperitoneal chemotherapy (CRS-HIPEC), and pelvic exenteration) enable longer survival for people with advanced CRC. Yet, virtually no qualitative research has explored the experiences and perspectives of these survivors. This study therefore aims to explore the different needs and views of survivorship care of people who received these treatments for advanced CRC.
Adult survivors of CRC are being recruited 0.5-2 years post-surgery from a major Australian public tertiary referral hospital. N=20-40 survivors who have undergone pelvic exenteration or CRS-HIPEC will be recruited. Participant demographic and clinical data are being collected from the hospital’s electronic medical records. All participants will complete the Functional Assessment of Cancer Therapy – Colorectal (FACT-C), Distress Thermometer, and Comprehensive Score for Financial Toxicity (COST) questionnaires, with scores undergoing descriptive analysis, and participate in a qualitative semi-structured telephone interview, analysed via the framework approach.
Preliminary analysis of eleven interviews (n=8 CRS-HIPEC, n=3 pelvic exenteration) reveals some advanced CRC survivors report post-surgical complications and chemotherapy-induced peripheral neuropathy, which can limit physical activity. Participants reportedly manage these through distraction, positive reframing, and contact with other CRC survivors. Most participants appeared satisfied with their cancer treatment teams. Some viewed their GPs as important coordinators in their health care. CRC survivors reported being more cautious about leaving the house due to COVID-19, and view the change to telehealth as less personal; however, rural/regional participants prefer telehealth’s convenience.
The study findings will help guide development of interventions to improve the survivorship experience of patients with advanced CRC who receive pelvic exenteration and CRS-HIPEC treatments. This may include an information booklet, patient-reported outcome measure, clinical pathway, or targeted intervention.