Attention to physical problems after pelvic cancer

In conversations with representatives of patients’ associations, it has been shown that health care providers are poor at attending to symptoms and sequelae after treatment of urological, gynecological, and colorectal (cancer of the small pelvis) diseases. It may therefore be appropriate to draw attention to the fact that there is a recent program of care for pelvic cancer rehabilitation targeting both tertiary and primary care. [1].

The treatment arsenal against pelvic cancer includes surgery, radiation, cytostatics, and anti-hormone therapy, alone or in combination. Targeted therapy and immunotherapy may also be appropriate. Both cancer and its treatment can lead to problems with bowel function, urinary tract, and sexual function, which in turn can lead to a poor quality of life. Problems that the patient may experience are, for example, urgent urges to urinate or defecate, leakage, fragmented stools, diarrhea, dryness of the abdominal mucous membranes, vaginal stenosis, erectile dysfunction, dry ejaculation, discoloration of the ejaculate, decreased or absent orgasm, edema Lymphatic or pain in the pelvic area.

It is not clear that the patient comes forward with the complaint spontaneously, because it is of an intimate nature and the patient does not know that it can be treated. This means that it can be missed. Therefore, it is important for healthcare professionals to be aware of the symptoms that may occur. Many problems can be prevented or mitigated with bowel-regulating medications, topical estrogens, vaginal applicators, PDE-5 inhibitors, mini enemas, bile salt squares, nutritional advice, naturopathy, self-care advice, and so on. Some of the symptoms that concern the patient do not necessarily have to be a problem, if the individual gets help to understand what they are based on. This requires that healthcare professionals have knowledge of the subject and time to talk to the patient.

Regional cancer centers (RCCs) have a national pelvic cancer rehabilitation task force. Within the framework of this, each of the regional medical centers has a regional project manager whose task is to develop knowledge-building and take care of the problems that patients may have after cancer treatment of the small pelvis. We hope that the new sponsorship program that has been developed will be included, as well as other materials from the Working Group Regional Cancer Center websiteto become a tangible support for caregivers, thereby improving the care of patients who have undergone pelvic cancer treatment.

Lakartidningen.se 2023-08-16