Abstract

Bonnie Bristow, Laura D'Alimonte, Merrylee McGuffin, Ewa Szumacher, Margaret Fitch, Lisa Di Prospero
Odette Cancer Centre, Toronto, ON

Purpose: Evidence has shown that the prostate moves under the influence of the rectum and to a lesser extent the bladder; many radiation therapy departments have adopted standardized bladder filling/rectal emptying protocols for radiotherapy treatment. Daily treatments may be delayed until appropriate volumes are attained; impact of these delays on patients is unknown. The purpose of this study was to determine levels of anxiety, depression, distress and bother related to bowel preparation for prostate cancer patients undergoing radiation therapy treatment. 

Materials and Methods: A prospective cohort analysis of prostate cancer patients undergoing external beam radiation therapy was completed. Patients were assigned to one of three groups; Group A was standard of care, Group B was standard of care + increased educational information regarding bowel preparation, Group C was standard of care + increased educational information regarding bowel preparation + an anti-flatulent medication. Hospital Anxiety and Depression Scale, Distress Thermometer, and a Bowel Status Bother survey were completed by participants at the start of their course of radiation treatment, mid-way through and at the end. ANOVA testing reported differences in mean scores between the three groups. 

Results: Mean age of patients was 66 years; 50% of the 31 participants had a university education; 80% were married. Anxiety levels decreased over time in all groups (p= 0.03958) with no difference between groups (p=0.447806). Depression levels across time for each group remained low (p=0.577049). Overall distress levels associated with bowel preparation were reported low amongst each group, and no significant differences were reported (p=0.978). All groups reported high rates of quality of life. 

Conclusions: Findings from this study indicate that collectively across three groups and over time, there were low levels of anxiety, depression and distress from bowel preparation. Amount and quality of educational information, timing of it and the approach are important factors.