A qualitative study of anterior resection syndrome: the experiences of cancer survivors who have undergone resection surgery

This study aimed to explore how individuals recovered and adapted following surgical resection of their rectal cancer and the syndrome that occurs as a consequence of this operation. This syndrome, 'anterior resection syndrome', consists of frequency, urgency, fragmentation and incontinence of faeces, and is thought to occur in 90% of patients who have received this type of surgery. Little qualitative research has been undertaken in this area, and this study adds to current quality of life data and explores supportive care strategies that nurses could use to assist patients. This study uses a grounded theory approach and in-depth interviews to explore patient's experiences. Participants were recruited from a cancer unit within the UK. Participants were recruited from a total population sample of 27 patients who had received surgery from 2001 to 2002. Following eligibility criteria to exclude those who had disease progression, seven patients were identified 1 year following surgery. Interviews were used to explore the experience of the syndrome. Three categories were identified: adapting to the physical changes, psychological adaptation and stigma. A secondary theme, running throughout all these categories, was the feeling of confidence and normality. Although the physical changes were expected as a consequence of surgery, most participants described the difficulty in controlling and managing symptoms in their period of recovery. Developing a philosophical stance was important in managing the lack of control and returning to perceived normality, despite the social stigma of bowel problems. Information on a range of strategies to manage physical symptoms is helpful in providing supportive care. Understanding that patients often rely on inappropriate strategies for management and are reluctant to discuss symptoms is important. The specialist nurse has a role in providing supportive care in managing chronic symptoms following cancer treatment.