Sexual dysfunction, informed consent and multimodality therapy for rectal cancer
Section snippets
Patients and methods
We performed a retrospective review of the medical records of 53 consecutive patients from January 1993 through December 1998. All patients underwent potentially curative surgery at Roswell Park Cancer Institute and had biopsy-proven rectal neoplasm within 15 cm from the anal verge. The patient population included 51 patients with adenocarcinoma of the rectum, 1 patient with a sarcoma of the rectum, and 1 patient with a large rectal villous adenoma. The cohort included 37 men and 16 women
Results
The consents included a physician-directed discussion of the procedures to be performed as well as potential risks of therapy. All consents included a discussion of additional perioperative risks including bleeding and infection. Presurgical discussion of possible postsurgical sexual dysfunction was documented in 15 of 53 patients (28%). There were 37 men who underwent surgery, with documentation of preprocedural discussion in 15 (40%). No documentation of preprocedural discussion was found
Comments
Although sexual dysfunction following locoregional therapy for rectal cancer is a commonly encountered problem, our results revealed that a discussion between physician and patient regarding this potential complication frequently did not occur at our own institute. Seventy-two percent of the 53 presurgical consent forms reviewed did not contain any record of discussion of potential sexual morbidity. Although lack of documentation of discussion occurred for 40% of the male patients, the rate of
References (25)
- et al.
Treatment planning for colorectal cancerradiation and surgical techniques and value of small-bowel films
Int J Radiat Oncol Biol Phys
(1985) - et al.
Impotence following radical prostatectomyinsight into etiology and prevention
J Urol
(1982) - et al.
Clinical evaluation of nerve-sparing surgery combined with preoperative radiotherapy in advanced rectal cancer patients
Am J Surg
(1998) - et al.
Pre and posttreatment evaluation of sexual function in patients with adenocarcinoma of the prostate
Int J Radiat Oncol Biol Phys
(1990) - et al.
Sexual function disorders after local radiotherapy for carcinoma of the prostate
Radiother Oncol
(1988) - et al.
Elucidating the etiology of erectile dysfunction after definitive therapy for prostatic cancer
Int J Radiat Oncol Biol Phys
(1998) - et al.
Cancer statistics, 1998
CA Cancer J Clin
(1998) - et al.
Adjuvant postoperative fluorouracil modulated chemotherapy combined with pelvic radiation therapy for rectal cancerinitial results of Intergroup 0114
J Clin Oncol
(1997) Psychosocial responses of the patientaltered sexual health
- et al.
Male sexual function after abdominoperineal resection for rectal cancer
Dis Colon Rectum
(1983)