Abstract:

Background: Colorectal cancer (CRC) is a malignant tumor arising from the glandular epithelial cells of the large intestine (the colon). CRC incidence has been steadily rising worldwide, especially in developing countries that are adopting the “western “way of life. Obesity, sedentary lifestyle, red meat consumption, alcohol, and tobacco are considered the driving factors behind the growth of CRC. In Tanzania, colorectal cancer is the third in incidence. Previous study done at BMC evaluated on clinicopathological pattern of colorectal cancer and highlighted the challenging problem in the management of this disease. However, this study didn’t go further to study the health-related-quality of life among colorectal cancer patients who are already on chemotherapy treatment therefore there was a need to cover this gap of knowledge.


Study Methodology: This was a descriptive cross-sectional study aimed at determining chemotherapy complications and health-related quality of life among adult colorectal cancer patients at BMC with the use of EQ-5D-5L standardized questionnaire from January 2023 to June 2023. Statistical data analysis was done using STATA V15.0 Statistical software. Statistical tests were performed to test for association between number of chemotherapy cycles and health related quality of life.
 
Results: A total of 100 patients suffering from colorectal cancer were enrolled into the study, these patients were already on chemotherapy and attending their regular clinics at Bugando Medical Center. The median age of the study participants was 57 (IQR 44-64) years. Majority of patients had advanced stage of cancers and the most prevalent was stage IV disease 49 (49%). The most common histologic type of colorectal cancer was adenocarcinoma 96 (96%) and the rest was the squamous cell type 4%. The commonest location of the cancer was the rectum 47 (47%) and the appendiceal cancer was the least common 1 (1%). The commonest presentation of the cancer was abdominal pain 98 (98%), followed by bloating 90 (90%). Capecitabine-oxaliplatin chemotherapy combinations was the most common chemotherapy regimen 47 (47%). Chemotherapy complications were also assessed among study participants. About two-third of the study participants presented with chemotherapy related complications, the most common reported was vomiting 89 (89%), mucositis66(66%) and peripheral neuropathy50(50%). Other complications that were reported include hair loss 47(47%), hand foot syndrome 40 (40%), and anemia 28 (28%). The overall quality of life reported by study participants was poor among them all. According to the EQ-5D-5L score, most participants experienced pain/discomfort 76 (76%). The cancer stage only significantly affected mobility in the EQ-5D-5L score with [ p=0.04]. Additionally, there was no significant relationship between quality of life and chemotherapy cycle in pain and discomfort [ p=0.78] and anxiety [ p=0.74].

Conclusion: The commonest chemotherapy treatment combinations used at BMC is Capecitabine-oxaliplatin regimen 47 (47%) with about two-third of colorectal cancer patients present with complications related to chemotherapy which affected their overall quality of life Additionally this study has found higher rates of late presentation among colorectal cancer patients in our locality.