Research trial to help bowel cancer patients hits first stage target | News

A three-part research trial led by Royal Surrey’s Research, Development and Innovation Team has successfully completed recruitment of 380 bowel cancer patients across 26 hospitals in England for its first stage.

The CITRuS trial seeks to develop the way patients’ symptoms following their treatments for bowel cancer treatments are reported and communicated, to help improve health outcomes. 

In its first stage, the trial is focusing on whether patients taking part are willing and able to use electronic data collection to report their symptoms following treatment for their cancer. They are given the choice of using any electronic device, including phone, tablet or laptop to answer the questions.

Patients taking part in the trial start by filling in 12 questionnaires to give baseline information about their health and symptoms. Following their treatment, the patients then agree to fill in three or four questionnaires each month over a two-year period.

Launched in March 2022, the trial is headed up by Dr Alexandra Stewart, Consultant Clinical Oncologist and Lead Investigator. Professor Tim Rockall is the lead surgeon on the study.

Dr Stewart said: “The aims of the first stage of the trial are to capture bowel cancer patients’ experiences of their treatment and accurately record them in a way that is easy and acceptable for patients and efficient for researchers. With electronic data collection we can more easily identify patterns or ‘clusters’ of symptoms.

“Cancer follow-up appointments quite appropriately focus on checking that cancer hasn’t returned, but often the follow up doesn’t look into how treatments may have impacted a patient’s quality of life or affected their weight, sex life, bowel function, exercise routine, or sleep for example.

“Patients don’t always tell their doctor how they are feeling after their treatment, perhaps because they’re pushed for time or are embarrassed about symptoms. If patients are able to submit information electronically via a phone, laptop, tablet etc this lessens their embarrassment and helps us easily identify clusters of symptoms that may be affecting patients.

“The hope is that this will help find future treatments that can help patients, whether they have had radiotherapy, chemotherapy or surgery and identify the best time to deliver these treatments to patients.”

Charles Pascall, 68, a Royal Surrey patient who took part in the CITRuS trial said: “After being diagnosed with colorectal cancer, I was waiting for my radiotherapy treatment to start when I was invited to join the trial. As I was on the point of venturing out on a voyage into the unknown myself, I felt it was important to do whatever I could to help staff identify potential issues with treatment and help other patients.

“Filling out the surveys for the trial was very easy and taking part meant I could also join virtual update meetings with Dr Stewart and other patients where there was a feeling of being in a club, where people were keen to help each other.

“The possible side effects from my treatment that I was particularly interested in were peripheral neuropathy (sensitivity and tingling in hands and feet) because I’m a Type One diabetic and I know it can be painful. I think taking part in a research trials such as CITRuS is something I feel strongly about as anything that can help in the battle to fight cancer is to be encouraged.”

Royal Surrey’s research team is now working on the second stage of the study, CITRuS 2, which is trialling interventions for patients using the gathered data.

Helen Minnaar, Research Project Manager, said: “In the next stage, we will be looking at patients’ symptoms and the timing of the symptoms that have been revealed by the questionnaires, which will help us identify clusters of symptoms.

“For example, one of the interventions we are looking at is diet. If the patient records a weight loss of a certain amount, then automatically some advice will be sent electronically to that patient with suggestions as to how they can increase their weight, using leaflets and videos, customised to their symptoms.”

The third stage of the CITRuS trial will be a randomised trial designed to assess how well the interventions work.

CITRuS is funded by Guildford-based charities BRIGHT Cancer Care and Guts Charity.

Pictured above, from left to right: Professor Tim Rockall, Dr Alexandra Stewart and Helen Minnaar.