To kick off our very first Research News, I have looked at three very interesting and diverse pieces of research, covering management of PRD, prevention of PRD and quality of life.
Please send suggestions for inclusion in the next feature to ResearchNews@prda.org.uk.
Dr Tim Ward, Scientific Consultant Advisor, Pelvic Radiation Disease Association
Please note that the links below take you to the article abstracts, and that the full articles may be paywalled and only accessible by people who work for institutions with journal subscriptions.
Firstly, I would like to highlight a series of 4 articles on Pelvic Radiation Disease authored by Dr Helen Ludlow who is an Inflammatory Bowel Disease (IBD) Clinical Nurse Specialist, the Macmillan Nurse for Late Gastrointestinal Effects of Cancer Treatment and a Nurse endoscopist at the University Hospital Llandough, Cardiff, UK. Helen very kindly gave a presentation as part of PRDA’s Annual Friends’ Meeting (teleconference) in March 2020. Her slides are available here.
As part of her doctorate studies, Helen produced four superb papers on Pelvic Radiation Disease (PRD) which were published in early 2020 in the journal Gastrointestinal Nursing.
This article gives a concise up to date review of the current literature related to PRD. It highlights a growing awareness of issues surrounding gastrointestinal symptoms of PRD that can affect quality of life following treatment for the main pelvic cancers.
This follow-on article explores the experiences of people affected by PRD, including both the patient and their family and friends. The three main areas of concern by patients and their families were feelings of stigma, experiences of contact with healthcare services and the need, and occasional lack, of support from family and friends.
This third paper gets to the basics of diagnosis and cites the use of a simple diagnostic screening tool – the ALERT-B questions, which can easily be used to identify people who should have gastroenterology investigations. The paper also covers the importance of using a systematic approach to diagnosing and treating each gastrointestinal symptom, and will be very helpful to gastroenterology professionals.
The fourth paper tackles the important issue of health professionals’ lack awareness of PRD, and concludes, as PRDA knows very well, that the rising incidence of PRD and lack of specialist services suggests that the NHS needs to provide more care for patients beyond the end of their cancer treatment.
My second choice is ‘Long-term Consequences of Pelvic Irradiation: Toxicities, Challenges, and Therapeutic Opportunities with Pharmacologic Mitigators’ from a group headed by Professor Mark W. Dewhirst at the Duke Cancer Institute, USA. This paper has an excellent review of current literature related to the late effects of pelvic radiotherapy as well as details on the pathophysiology of radiation damage to the intestine. The main thrust of the paper is to explore mitigators of radiation toxicity, principally by pharmacological intervention.
The third study I have chosen is Life after Prostate Cancer Diagnosis. This was a pioneering collaboration between several UK universities and Public Health England which aimed to find out what effect prostate cancer and its treatment has had on men’s physical, emotional, and social wellbeing. The study group have published at least 15 papers to date on a range of topics including erectile dysfunction, decision regret, job loss, social distress and the experiences of BAME prostate patients and their partners. The study gives an important insight into the prevalence of problems, and what needs to improve in order to help men have better quality of life after prostate cancer diagnosis and treatment.
I do hope this first edition of Research News has been illuminating and useful. We welcome all feedback, guest bloggers, suggestions for publications and links to study websites on PRD research.
Modified: 4th August 2020