Rehabilitation targeted late adverse effects after radiotherapy for cervical cancer – Different gains in different settings

Abstract

Many cervical cancer survivors experience late adverse effects, and rehabilitation may alleviate symptoms. This study describes participants’ experiences with late adverse effects in daily living and with experiences of perceived rehabilitation in hospital, municipal, and a residential setting. Twenty-one cervical cancer survivors aged 40-72 years, curatively treated with concomitant radio-chemotherapy, with moderate/severe incontinence and sexual problems, participated in a 5-day residential rehabilitation intervention. Three focus group interviews were conducted and analyzed. Late adverse effects like incontinence, sexual problems, tinnitus and pain severely restricted everyday life. The participants described rehabilitation in hospital settings as fragmented, but several of the participants benefitted from the physical rehabilitation in municipal settings; however, no participants were offered sexual rehabilitation. In the residential setting, they gained a sense of connectedness and confidence in association with peers. More time to reflect and the anonymity gave opportunity to work with sensitive issues e.g. sexuality. Increased knowledge about late adverse effects and tools to alleviate these made the participants prepared to regain command of their lives. In conclusion, incontinence and tinnitus had especially impact on social life and every day activities. The participants benefitted especially from rehabilitation in two settings (municipal and residential). Intensively psychosocial interventions allowed participants to work with underlying problems. Women with sexual and/or incontinence problems favored the residential rehabilitation due to anonymity.