Prediction of rehabilitation needs after treatment of cervical cancer: what do late adverse effects tell us?

Women treated for cervical cancer with radiotherapy and chemotherapy have reported serious bowel, vaginal, and sexual late effects. The purpose of this study was to describe late adverse effects, health-related quality of life, and self-efficacy in a representative Danish cervical cancer population in order to describe rehabilitation needs.

Women, mean age 55 years, treated for cervical cancer from January 2010 to July 2013, who were alive and without known relapse/metastases were included in this cross-sectional study. EORTC QLQ C30 and CX24 and self-efficacy questionnaires were sent to all participants.

The participation rate was 85/107 (79%). Participants below 45 years had significantly more menopausal symptoms and lower body image scores compared to elderly women. The frequency of participants with menopausal symptoms decreased with time since diagnosis. Symptom experience was significantly higher in participants with locally advanced disease than in those with local disease. Self-efficacy was significantly lower in participants with locally advanced disease. The incidence of lymphedema was significantly higher among participants who were obese. Multiple analyses showed impaired quality of life, e.g., a lower body image and self-efficacy score, correlated with increasing BMI. Women who had surgery had greater risk of lymphedema, and women who received chemotherapy during treatment had a lower quality of life. All but one received radiotherapy.

This study found that young, obese survivors with locally advanced cervical cancer and survivors who received chemotherapy may have a serious risk of developing late adverse effects; thus, rehabilitation should target these needs.