Spectrum of chronic sequelae after colorectal cancer treatment and their domains of impact on family members.
| Sequela | Estimated prevalence in survivors | Clinical features | Family and relational impact | Key references |
|---|---|---|---|---|
| Bowel dysfunction/LARS | 50–90% bowel dysfunction and 40–50% major LARS after sphincter-preserving rectal surgery20–39% bowel dysfunction after colon cancer resection | Urgency, frequency, clusteringIncontinence, emptying difficulty | Restricted social and sexual lifePartner as ‘silent co-pilot’Toilet planning; hypervigilance | [5, 10–15] |
| Permanent or temporary stoma | 15–25% of rectal cancer casesSelected colon cancer | Appliance management, leakageSkin complicationsBody image change | Intimacy avoidance; stigmaSpouse-reported information and support gap | [8, 9, 16–18] |
| Sexual dysfunction | Erectile/ejaculatory dysfunction in up to 50% of menDyspareunia/dryness in up to 40% of women | Autonomic and somatic nerve damageBody image issuesFatigue-related reduced desire | Most persistent unmet needMutual withdrawal if unaddressedPartner rarely prepared | [16, 17, 19–21] |
| Urinary dysfunction | 20–40% after pelvic surgery or radiotherapy~50% moderate to severe long-term symptoms | Urgency, frequencyIncomplete emptying, nocturia | Sleep disruption for both partnersShame; reduced social participation | [22, 23] |
| Fatigue, CIPN, and chronic pain | Fatigue in 25–40%CIPN in 30–40% after oxaliplatin | Persistent tirednessSensory/motor symptomsPelvic or neuropathic pain | Shift of household workloadCaregiver fatigue and sleep disturbanceRole renegotiation | [4, 24] |
| Fear of cancer recurrence | Clinically significant in ~45–55% of survivors~40–50% of caregivers | Intrusive worry, avoidanceScan-triggered distress | Dyadic fear of cancer recurrence loopPredictor of later depression and anxiety in both partners | [25–27] |
| Psychological sequelae and body image | Depression in ~19%; anxiety in ~21% of long-term survivors (vs. 12.8%/11.8% in matched norm population) | Altered self-image (scars, stoma, functional loss)Low self-esteem | Increased risk of partner depression and anxietyMarital strain | [7, 28, 29] |
CIPN: chemotherapy-induced peripheral neuropathy; LARS: low anterior resection syndrome.
During the preparation of this manuscript, the authors used Claude (Anthropic) to assist with language editing. All output was reviewed and edited by the authors, who take full responsibility for the content of the publication.
LWF and BTO: Conceptualization, Data curation, Investigation, Writing—original draft, Writing—review & editing. JR: Conceptualization, Writing—original draft, Supervision, Writing—review & editing. All authors read and approved the submitted version.
The authors declare they have no conflicts of interest.
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