Following a diagnosis of rectal cancer, a team of healthcare professionals will help patients decide which treatment is best for them. Lots of research has gone into guiding treatment decisions based on where in the bowel the cancer is, how far it has grown and whether it has spread. But less research has been carried out into patient preferences and which outcomes patients would prioritise.
Through our small grant funding, Professor Anne Miles at the School of Psychological Sciences, Birkbeck University of London, and a team of other researchers set out to understand how different groups of patients with rectal cancer felt about different treatment outcomes.
Their research, published in the journal Colorectal Disease at the start of February, showed that reducing the chances of cancer coming back was a priority across the three different groups they questioned – those who had rectal cancer and had a stoma, those who had rectal cancer but no stoma and those without cancer. However, other preferences were significantly different across the groups. For those without a stoma, avoiding a stoma was the first or second most important factor. In contrast, for those with a stoma, avoiding a stoma was the least important factor.
Their research also found that people were willing to accept increases in the chances of cancer coming back to avoid treatment outcomes such as a permanent stoma or poor bowel function, but again this varied across the groups. Patients with no stoma following rectal cancer treatment were more likely to choose no stoma again, even if this meant an increase in the chances of cancer coming back or poor bowel function. However, patients with a stoma were more likely to choose a stoma to avoid poor bowel function. This research showed that people with experience of a stoma or bowel dysfunction were more likely to accept it.
Professor Anne Miles said: “We know that people are often highly fearful of having a stoma, but thanks to our research, we can see that people with a stoma following rectal cancer treatment are less averse to it than people who have not had one. Hearing from people who have direct experience of different treatment outcomes will help newly diagnosed patients be more prepared for the effects of treatment so they can make informed decisions.”