Treatment complications among long-term survivors of cervical cancer: treated by surgery or radiotherapy
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REVIEW
Treatment complications among long-term survivors of cervical cancer: treated by surgery or radiotherapy Kamal A. Elghamrawi • Mamdouh H. Haggag Emmad E. Habib
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Received: 31 July 2011 / Accepted: 2 November 2011 / Published online: 11 November 2011 Ó Springer-Verlag 2011
Abstract This study assesses the morbidity and complications of treatment among long-term survivors of cervical cancer. Ninety-eight female patients who were diagnosed and treated from invasive carcinoma of the cervix uteri 5 years or more are included in this study. All the cases were free of disease and had survived up to December 2010. Forty-one cases were treated with radical hysterectomy with removal of the lymph nodes (Wertheim’s surgery) (42%). Radical radiation therapy was given to 57 cases (58%) according to our treatment protocol; weekly cisplatin was given concomitantly with radiation. Although urinary adverse effects were more prevalent among the radiation group, the difference was not statistically significant. Bowel dysfunction was more prevalent and statistically significant (p \ 0.001) among the radiotherapy arm. Dysfunctions recorded included change in bowel habit, diarrhea, constipation, tenesmus, soiling of clothes and or flatulence. However, their severity was grade 1–2 only. The frequency of small intestinal obstruction was comparable in both arms. Pelvic vein thromboses had a tendency to occur among the surgical group especially in obese females (p value 0.005). The frequency of sexual dysfunction was comparable in both groups with no statistical difference. It was age related. The younger the patients’ ages, the more was the sexual complaint irrespective to the treatment modality. Sexual problems included dyspareunia from vaginal stenosis shortening or dryness, vulval soreness from itching and dryness. Bearing in mind that many patients had more than one health complaint. The remaining cases denied the
K. A. Elghamrawi M. H. Haggag E. E. Habib (&) Faculty of Medicine, Department of Clinical Oncology, Cairo University, Cairo, Egypt e-mail: [email protected]
presence of any complications and stated that they had a normal life style. Keywords Radiation
Cervical cancer Quality of life Surgery
Introduction Cervical cancer is both a preventable and a curable disease. Preventable by cervical screening and curable, especially if identified at an early stage. In developing countries, which lack screening programs, the incidence may be up to six times higher than in developed countries. Moreover, up to 70% of patients present with advanced disease [1, 2]. Given the similar 5-year survival rates of both radical surgery and radiotherapy (RT) in early cervical cancer, attention should be focused on the complication rate and side effects profile of each treatment modality when offering management options. As a result, complications developed due to treatment may negatively affect the quality of life of cervical cancer survivors. Increased information on the likelihood of chronic and late effects of treatment
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