Anna Axelsson: Quality of life after anal cancer treatment


A significant number of anal cancer patients not only survive but face chronic side effects post-treatment. In her doctoral thesis, Anna Axelsson sheds light on enduring challenges faced by survivors after anal cancer treatment.

Anna Axelsson is an oncology nurse specialist and the care unit head at oncology outpatient clinics 1 and 2 at Sahlgrenska University Hospital.

Dissertation defense: 22 March 2024 (click for more info)
Doctoral thesis: Quality of life and long-term side effects after anal cancer treatment
Research area: Surgery
Sahlgrenska Academy, The Institute of Clinical Sciences

Anal cancer, though rare, affects around 200 individuals annually in Sweden. Treatment typically involves a combination of radiotherapy and chemotherapy, with approximately 10% of patients undergoing major pelvic surgery.

The cure rate is high. A large proportion of patients become cancer survivors, living with side effects after treatment.

What is your research about?
“It’s about finding out how patients are doing in the long term and whether it changes over time after completing treatment. My studies focus on quality of life and late side effects, based on extensive questionnaires three and six years post-diagnosis, covering aspects like bowel, urine, and sexual function,” says Anna Axelsson, a specialist nurse in oncology at Sahlgrenska University Hospital, and continues:

“The last part of the study involves interviews with patients who underwent pelvic surgery, exploring their experiences of side effects and quality of life about a decade after surgery.”

The Anal Cancer Foundation has designated March 21 as Anal Cancer Awareness Day to raise awareness about the disease and show support for those affected. It is the day before Anna Axelsson’s dissertation defense.
Photo: Getty Images

Chronic side effects

The cover image, by Emelie Axelsson, symbolizes the balance between cure and side effects. Anna Axelsson: “We need to be light-handed in finding the right balance for each patient and strong-hearted in our mission to improve outcomes for all our patients.”

What are the main research findings?
“Anal cancer survivors live with significant chronic side effects where bowel, urine, and sexual functions are affected, with some functions getting worse over time. Despite varying degrees of impact from side effects, the overall quality of life does not decline over time, suggesting patients’ adaptation to their situation.”

What patient benefit can the results provide?
“The results may offer patients a clearer picture of life after anal cancer treatment. Furthermore, they underscore the need to continue treatment development to reduce side effects while maintaining cure,” says Anna Axelsson, recently appointed as the care unit head at oncology outpatient clinics 1 and 2.

“A deeper understanding”

What has been enjoyable and challenging about the doctoral project?
“It was highly rewarding to meet patients during my fourth sub-study, where I conducted interviews nationwide. It provided me with a deeper understanding and respect for the human ability to adapt. One challenge has been balancing doctoral studies with clinical work.”

Text: Jakob Lundberg