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Diarrhea, Constipation, and Obstruction in Cancer Management

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The MASCC Textbook of Cancer Supportive Care and Survivorship

Abstract

Gastrointestinal symptoms encountered by cancer patients include those not only induced by the primary malignancy but also by its treatment. These symptoms range from being nonspecific and annoying to life-threatening and a harbinger for imminent death. Symptoms from the primary tumor may be resolved with surgery, but subsequent adhesions may produce intermittent discomfort. Opiates may relieve somatic pain but induce severe pain and distress from constipation and bowel obstruction. When symptoms impact one’s quality of life, major efforts and support may be required to prevent a decreased quantity of life. The clinical judgment and experience of the practitioner impact not only which intervention is chosen but also the timing of the specific therapeutic modality. For patients with gastrointestinal symptoms, the management of iatrogenic diarrhea, constipation, and obstructive symptoms is central to the patient’s well-being. As the toxicities from conventional cytotoxic chemotherapeutic agents are predictable and manageable, prescribing “targeted agents” presents new challenges and opportunities in cancer care. The era of “molecular medicines” is here, and going forward with dose escalations and combinations is the immediate future in treating cancer. Success will depend upon not only identifying adverse effects from these anticancer agents but also in the development of supportive care pathways that controls or improves symptom burden.

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  1. Division Chief Medical Oncology, Department of Medicine, Albert B. Chandler Hospital, Lexington, KY, USA

    Lowell B. Anthony

  2. Markey Cancer Center, University of Kentucky, Lexington, KY, USA

    Aman Chauhan

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  1. University of South Australia, Adelaide, SA, Australia

    Ian Olver

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Anthony, L.B., Chauhan, A. (2018). Diarrhea, Constipation, and Obstruction in Cancer Management. In: Olver, I. (eds) The MASCC Textbook of Cancer Supportive Care and Survivorship. Springer, Cham. https://doi.org/10.1007/978-3-319-90990-5_28

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