Pain, nausea and anxiety during intra-uterine brachytherapy of cervical carcinomas

The aim of this quality-assurance study was to assess how patients with cancer of the uterine cervix experience different aspects of care during brachytherapy treatment. Twenty patients scheduled for intrauterine brachytherapy using an afterloading technique and 20 controls with other gynaecological malignancies, undergoing a gynaecological palpation under anaesthesia, were given a questionnaire to complete. The questionnaire consisted of ten items related to information received, pain, sleep, nausea and food intake. Each item was constructed as a statement to be answered on a five-point Likert-like scale, with alternatives ranging from very positive to very negative. Among the results, 17 of the 20 brachytheraphy patients reported that they experienced great anxiety before admission. The corresponding figure for the control group was 9/20 (P < 0.01). As regards pain, 13/20 and 0/20, respectively, suffered from moderate or severe pain (P = 0.0000), despite standard analgesic medication. Twelve of the brachytherapy patients praised the ordinary hospital liquid foods, whereas 8/20 would clearly have preferred alternative menus. In the control group 18/20 approved of the food and 2/20 did not (P < 0.05). The results clearly underline the importance of quality-assurance studies that focus on the side-effects of treatment. This study has resulted in a new care programme with intensified prophylactic treatment of pain and nausea and a novel form of "picking food", i.e. pieces of vegetables, meat and chips that are easy to eat in a supine position.