Evaluation of Depression, Anxiety, and Sexual Function in Rectal Cancer Patients Before and After Neoadjuvant Chemoradiotherapy


DAĞDELEN M., KURT ÇATAL T., DEMİREL Ö. F., ÜRÜN E., KAÇAR S., Cepni K., ...More

JOURNAL OF GASTROINTESTINAL CANCER, vol.54, no.4, pp.1347-1352, 2023 (ESCI) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 54 Issue: 4
  • Publication Date: 2023
  • Doi Number: 10.1007/s12029-023-00939-y
  • Journal Name: JOURNAL OF GASTROINTESTINAL CANCER
  • Journal Indexes: Emerging Sources Citation Index (ESCI), Scopus, EMBASE, MEDLINE
  • Page Numbers: pp.1347-1352
  • Keywords: Arizona Sexual Experiences, Beck Depression Anxiety Inventory, Neoadjuvant treatment, Radiotherapy, Rectum cancer
  • Istanbul University Affiliated: Yes

Abstract

ObjectiveThe association of treatment-related side effects and tumor characteristics with sexual function, depression, and anxiety were investigated in patients with locally advanced rectum cancer (LARC) receiving neoadjuvant chemoradiotherapy (CRT).Material and MethodsThirty-two patients who received neoadjuvant CRT with LARC were included. The Arizona Sexual Experiences (ASEX) Scale was used to determine the sexual function status whereas the Beck Depression Inventory (BDI) and the Beck Anxiety Inventory (BAI) were used to evaluate the depression and anxiety status of the patient, respectively. The patients were asked to fill these scales before and at least 4 weeks after the neoadjuvant CRT. T-test and Mann-Whitney U test were used for the comparison of values.ResultsMedian age was 52.5 years (range: 33-76). Twenty-six patients were male, and 6 patients were female. At presentation, the tumor was located mostly in lower third rectum (72%), and 69% of the patients had T3 tumors. There was a statistically significant deterioration in the sexual functions of the patients (p < 0.001), a statistically significant decrease in their anxiety level after CRT (p: 0.037). Depression level was changed from mild to minimal during this process (p: 0.17). A significant deterioration in the ASEX scale was observed especially in patients with grade 2 and above gastrointestinal side effects (p: 0.01).ConclusionThis prospective study showed that the patient's anxiety and depression levels had decreased during the treatment process probably due to the decrease in the patient's symptoms. However, deterioration of the sexual function status which might be correlated to increased gastrointestinal side effects during CRT has been observed. So, clinical and psychiatric support including therapies for sexual dysfunctions is needed for LARC patients during and after the neoadjuvant CRT.