Background: The concerns of patients with rectal cancer are not well known. Prospective studies following patients pre and postoperatively are rare.

Aim: The aim of the study was to assess worries and concerns, Quality of life (QOL) preoperatively, one, three and six months postoperatively in patients operated for rectal cancer with a stoma.

Methods: Patients operated for rectal cancer between April 2003-March 2005 were asked to participate in the prospective study. Sixty-four patients participated with a median age of 67, range 30-87, (F/M = 25/39). Fifty patients were operated with a colostomy and 14 patients with a loop-ileostomy. Worries and concerns were assessed using Rating form of patient concerns (RFIPC).  Patients´ definition of QOL as well as perceived QOL and health on a visual analogue scale was evaluated.

Results: The overall concern was greater on all items (RFIPC) preoperatively than six months postoperatively. Greatest concerns preoperatively were fear of cancer and being a burden (or dependent on others) followed by, dying early, the uncertain nature of the disease, loss of bowel control, producing unpleasant odour, being operated on, and having an ostomy.  

Patients perceived health improved from preoperatively until six months postoperatively whereas QOL was perceived similar preoperatively as six months postoperatively. Patients´ definitions of QOL concerned mainly family, friends, social life and health.

Conclusion: Knowledge of the specific responses of these patients could be useful in assisting health professionals to understand better patients´ fears and uncertainties as well as determine issues for which counselling might be of value.

Learning objectives:To increase the knowledge of factors influencing life in patients with rectal cancer and a stoma. How to implement aspects of concerns and QOL in the care of patients with rectal cancer and a stoma.