This includes management of physical and psychological symptoms and side effects across the continuum of the cancer experience from diagnosis through anticancer treatment to post-treatment care. Patients with advanced colorectal cancer should have access to multidisciplinary care including but not limited to:
- Palliative care specialists
- Dietitians and nutritional counsellors
- Spiritual care practitioners
- Rehabilitation therapists, including occupational therapy, physical therapy and speech therapy
- Wound or stoma care specialists
- Intimacy and sexuality counsellors
- Fertility therapists
Patients with advanced colorectal cancer should be regularly screened for psychosocial distress, including depression, financial distress and employment issues in addition to the common physical problems that arise from late toxicities of chemotherapy and radiation therapy and the cancer. Guidelines regarding the management of common problems faced by patients with advanced colorectal cancer including bowel dysfunction, fatigue, urinary incontinence and sexual dysfunction, peripheral neuropath are available from National Comprehensive Cancer Network (NCCN). Links to comprehensive palliative care resources are available at eviQ Cancer treatments on line. Management of common chemotherapy toxicities in patients with advanced colorectal cancer are available at eviQ Cancer Treatments online.
Evidence also suggests that early referral to palliative care in advanced cancer is associated with better outcomes in terms of quality of life and aggressiveness of care at the end of life. Patients should be encouraged to develop an advance care plan. Ensure carers and families receive information, support and guidance about their role according to their needs and wishes.
See Additional resources for further supportive care resources.
- National Comprehensive Cancer Network (NCCN). Survivorship. Version 1.2017. NCCN; 2017.
- Haines IE. Managing patients with advanced cancer: the benefits of early referral for palliative care. Med J Aust 2011 Feb 7;194(3):107-8 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/21299481.
- Temel JS, Greer JA, Muzikansky A, Gallagher ER, Admane S, Jackson VA, et al. Early palliative care for patients with metastatic non-small-cell lung cancer. N Engl J Med 2010 Aug 19;363(8):733-42 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/20818875.
- Australian Health Ministers' Advisory Council (AHMAC). A National Framework for Advance Care Directives. AHMAC; 2011.
- Palliative Care Australia. Standards for Providing Quality Palliative Care for all Australians. Canberra: Palliative Care Australia; 2005.