Can Nurses Manage Gastrointestinal Symptoms Arising from Pelvic Radiation Disease?

2011 ◽  
Vol 23 (8) ◽  
pp. 538-551 ◽  
Author(s):  
B. Benton ◽  
C. Norton ◽  
J.O. Lindsay ◽  
S. Dolan ◽  
H.J.N. Andreyev
Keyword(s):  
Gastrointestinal Symptoms ◽  
Pelvic Radiation

Gastrointestinal symptoms of pelvic radiation disease (part 1): literature review

2020 ◽  
Vol 18 (2) ◽  
pp. 40-45 ◽  
Author(s):  
Helen Ludlow ◽  
John Green
Keyword(s):  
Quality Of Life ◽  
Side Effects ◽  
Literature Review ◽  
Patient Experience ◽  
Gastrointestinal Symptoms ◽  
Pelvic Radiation ◽  
Gi Symptoms ◽  
Pelvic Cancer ◽  
The Impact

Radiotherapy used to treat cancers in the pelvic region can have lasting side effects, and the persistence of these symptoms for 3 months or more is described as pelvic radiation disease (PRD). The growing number of pelvic cancer patients being diagnosed and successfully treated is increasing the incidence of PRD. This review examines the literature on the gastrointestinal symptoms of PRD. This includes how PRD is defined, how it is identified and how it relates specifically to the three pelvic cancers in which it most commonly manifests (prostate, gynaecological and colorectal). It pays particular attention to the impact of PRD on patient experience and quality of life. This review is the first part in a series on the GI symptoms of PRD.

Gastrointestinal symptoms of pelvic radiation disease (part 2): impact on patients and carers

2020 ◽  
Vol 18 (3) ◽  
pp. 44-49 ◽  
Author(s):  
Helen Ludlow
Keyword(s):  
Quality Of Life ◽  
Gastrointestinal Tract ◽  
Social Impact ◽  
Gastrointestinal Symptoms ◽  
Healthcare Services ◽  
Framework Analysis ◽  
Pelvic Radiation ◽  
Areas Of Concern ◽  
Stigma Experiences

Background: Radiotherapy for pelvic cancers can affect any organ within the pelvis, including the gastrointestinal tract. These late effects, or consequences of treatment, can have a significant impact. These symptoms are collectively known as pelvic radiation disease (PRD). Aims: To identify and consider the experiences of people affected by PRD, including both the patient and their family and friends. Methods: Exploratory interviews were conducted with patients and their carers. The transcripts underwent framework analysis to identify key themes. Findings: Three main areas of concern were feelings of stigma, experiences of contact with healthcare services and the need, and occasional lack, of support from family and friends. Conclusion: PRD has a significant physical, psychological and social impact on quality of life for those affected, as well as their carers.

Algorithm-based management of patients with gastrointestinal symptoms in patients after pelvic radiation treatment (ORBIT): a randomised controlled trial

The Lancet ◽  
2013 ◽  
Vol 382 (9910) ◽  
pp. 2084-2092 ◽  
Author(s):  
H Jervoise N Andreyev ◽  
Barbara E Benton ◽  
Amyn Lalji ◽  
Christine Norton ◽  
Kabir Mohammed ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Radiation Treatment ◽  
Controlled Trial ◽  
Gastrointestinal Symptoms ◽  
Pelvic Radiation ◽  
Randomised Controlled

Sucralfate in the Prevention of Treatment-Induced Diarrhea in Patients Receiving Pelvic Radiation Therapy: A North Central Cancer Treatment Group Phase III Double-Blind Placebo-Controlled Trial

2000 ◽  
Vol 18 (6) ◽  
pp. 1239-1245 ◽  
Author(s):  
James A. Martenson ◽  
John W. Bollinger ◽  
Jeff A. Sloan ◽  
Paul J. Novotny ◽  
Rodolfo E. Urias ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Treatment Group ◽  
Cancer Treatment ◽  
Gastrointestinal Symptoms ◽  
Phase Iii ◽  
Double Blind ◽  
North Central ◽  
Pelvic Radiation ◽  
Significant Difference ◽  
Patient Reported

PURPOSE: Randomized studies have suggested that sucralfate is effective in mitigating diarrhea during pelvic radiation therapy (RT). This North Central Cancer Treatment Group study was undertaken to confirm the antidiarrheal effect of sucralfate. Several other measures of bowel function were also assessed.PATIENTS AND METHODS: Patients receiving pelvic RT to a minimum of 45 Gy at 1.7 to 2.1 Gy/d were eligible for the study. Patients were assigned randomly, in double-blind fashion, to receive sucralfate (1.5 g orally every 6 hours) or an identical looking placebo during pelvic RT.RESULTS: One hundred twenty-three patients were randomly assigned and found assessable. Overall, there was no significant difference in patient characteristics between those receiving sucralfate and those receiving placebo. Moderate or worse diarrhea was observed in 53% of patients receiving sucralfate versus 41% of those receiving placebo. Compared with patients receiving placebo, more sucralfate-treated patients reported fecal incontinence (16% v 34%, respectively; P = .04) and need for protective clothing (8% v 23%, respectively; P = .04). The incidence and severity of nausea were worse among those taking sucralfate (P = .03). Analysis of patient-reported symptoms 10 to 12 months after RT showed a nonsignificant trend toward more problems in patients taking sucralfate than in those taking placebo (average, 2.3 v 1.9 problems, respectively; P = .34).CONCLUSION: Sucralfate did not decrease pelvic RT-related bowel toxicity by any of the end points measured and seems to have aggravated some gastrointestinal symptoms.

Gastrointestinal symptoms of pelvic radiation disease (part 4): professional awareness and specialist support

2020 ◽  
Vol 18 (5) ◽  
pp. 30-34
Author(s):  
Helen Ludlow ◽  
Nabihah Malik ◽  
Jeff Turner ◽  
John Green ◽  
Louise Hanna
Keyword(s):  
Gastrointestinal Symptoms ◽  
Third Sector ◽  
Screening Tools ◽  
Pelvic Radiation ◽  
Patient Reports ◽  
South Wales ◽  
Specialist Services ◽  
Gi Symptoms ◽  
Rising Incidence

This is the fourth and final article in a series on the gastrointestinal (GI) symptoms of pelvic radiation disease (PRD). Published studies and patient reports suggest that health professionals lack of awareness of PRD. This professional awareness can be improved with third-sector advocacy and provision of simple screening tools, such as Assessment of Late Effects of Radiotherapy-Bowel (ALERT-B). In South Wales, patients with suspected PRD are referred to a PRD specialist nurse in either a gastroenterology clinic or a gynae-oncology follow-up clinic. These two nurse-led clinics demonstrate different ways to identify, assess and manage patients with late GI effects of PRD. Data from these clinics suggest that systematic investigations based on appropriate guidance are effective in identifying these symptoms, many of which can be managed or treated. The rising incidence of PRD and lack of specialist services suggests that the NHS needs to provide more funding to care for patients beyond the end of their cancer treatment.

scholarly journals Guidance: The practical management of the gastrointestinal symptoms of pelvic radiation disease

2014 ◽  
Vol 6 (1) ◽  
pp. 53-72 ◽  
Author(s):  
H Jervoise N Andreyev ◽  
Ann C Muls ◽  
Christine Norton ◽  
Charlotte Ralph ◽  
Lorraine Watson ◽  
...  
Keyword(s):  
Gastrointestinal Symptoms ◽  
Pelvic Radiation ◽  
Practical Management

scholarly journals Phase III, Double-Blind Study of Depot Octreotide Versus Placebo in the Prevention of Acute Diarrhea in Patients Receiving Pelvic Radiation Therapy: Results of North Central Cancer Treatment Group N00CA

2008 ◽  
Vol 26 (32) ◽  
pp. 5248-5253 ◽  
Author(s):  
James A. Martenson ◽  
Michele Y. Halyard ◽  
Jeff A. Sloan ◽  
Gary M. Proulx ◽  
Robert C. Miller ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Gastrointestinal Symptoms ◽  
Phase Iii ◽  
Double Blind Study ◽  
Double Blind ◽  
North Central ◽  
Pelvic Radiation ◽  
Patient Reported ◽  
Bowel Movements ◽  
To Receive

PurposeTo assess the effectiveness of depot octreotide for the prevention of diarrhea during pelvic radiation therapy.Patients and MethodsPatients receiving pelvic radiation therapy (planned minimum dose, 45 Gy; 1.7 to 2.1 Gy daily) were eligible for the study. From May 10, 2002, through October 14, 2005, 125 patients were randomly allocated in a double-blind fashion to receive octreotide (100 μg, administered subcutaneously on day 1, followed by depot octreotide, 20 mg, administered intramuscularly on days 2 and 29; n = 62) or to receive a placebo (n = 63).ResultsGrade 0, 1, 2, and 3 diarrhea were observed in 18%, 31%, 31%, and 21% of patients in the octreotide arm, respectively, and in 25%, 32%, 22%, and 21% of patients in the placebo arm, respectively (P = .64). Grade 0, 1, 2, and 3 abdominal cramps were observed in 32%, 45%, 21%, and 2% of patients receiving octreotide, respectively, and in 51%, 24%, 21%, and 5% of patients receiving the placebo, respectively (P = .053). Some patient-reported symptoms were worse in the octreotide group, including nocturnal bowel movements (70% v 45%; P = .004), clustering of bowel movements (90% v 69%; P = .004), and bleeding with bowel movements (57% v 35%; P = .01).ConclusionAs administered in this study, octreotide did not decrease diarrhea during pelvic radiation therapy. Some gastrointestinal symptoms were worse in patients treated with octreotide. Octreotide is not indicated for prevention of diarrhea during pelvic radiation therapy.

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